Family physician program in Iran, patients satisfaction in a multicenter study

Factors influencing contracting of residents with family doctors in China: a national cross-sectional survey

BACKGROUND

Family doctor contract services (FDCS) have been introduced in China in 2009 [1] and rapidly expanded recently. This study sought to investigate factors that influenced the willingness of Chinese residents to use FDCS.

METHODS

We employed multistage stratified and convenience sampling to administer questionnaires to 1455 Beijing, Qinghai, and Fujian residents. The willingness of residents in each province to contract family doctors was analyzed using the chi-square test and binary logistic regression.

RESULTS

The analysis in this study found that the signing rate of family doctors in China was about 27.77%, with differences in the signing up levels in Beijing (13.68%), Fujian (64.49%) and Qinghai (11.22%). In addition, the binary logistic regression results emphasized the relative importance of age, education, medical preference and policy knowledge on the willingness to sign up. Distrust of family doctors' medical skills (65.7%), not knowing how to contract (47.8%), and not knowing what medical problems can be solved (41.1%) were the top three reasons accounting for the reluctance of residents to contract with family doctors.

CONCLUSION

Residents from different backgrounds have different willingness to sign up, so the specific circumstances and needs of different groups should be taken into account. In order to increase the signing-up rate, consideration can be given to promoting the family doctor model in Fujian throughout the country. Individual hesitation can be eliminated by increasing the reimbursement rate of health insurance, reducing the out-of-pocket expenses of contracted patients, and providing incentives of certain discounts for consecutive contracted patients.

Patients' satisfaction with healthcare services providers and its determinants in the urban family physician program in Iran: A cross-sectional study

INTRODUCTION

The quality of healthcare services can be determined by patient satisfaction as it affects the performance, sustainability, and durability of health services. This study aims to determine patients' satisfaction with healthcare service providers and its determinants in the urban family physician program in Fars and Mazandaran provinces, Iran.

METHODS

A cross-sectional study was conducted on the populations covered by the urban family physician program in Fars and Mazandaran provinces in 2016. In total, 864 households were selected in each province using random cluster sampling. Socio-demographic variables and underlying factors were gathered. Patient satisfaction levels were evaluated using a validated questionnaire.

RESULTS

Of the 1,480 participants with a mean age of 46.9 ± 14.2 years, 53.3% lived in Fars province and 74.2% were female. Furthermore, 67.9% of the patients were satisfied with their healthcare service providers. A higher satisfaction level was observed among the patients who resided in Fars province, lived in cities with <100,000 residents, walked <10 minutes to the family physician's office, had a family physician they previously knew, accepted the family physician, had a positive attitude towards the importance of having a family physician and a referral system, and had adequate knowledge of the family physician program.

CONCLUSION

The results indicated that two-thirds of the patients were satisfied with healthcare service providers. Several socio-demographic variables were associated with the patients' satisfaction levels. Improving the family physician program by providing adequate medical equipment and monitoring physicians' performance could increase patient satisfaction and improve the sustainability of the program.

Satisfaction and Dissatisfaction Toward Urban Family Physician Program: A Population Based Study in Shiraz, Southern Iran

Background:

A national project of extending a family physician program to urban areas has been started since May 2013 in Iran. The present study aimed to detect correlates of people's satisfaction and dissatisfaction about urban family physician program.

Methods:

This cross-sectional and population-based study was conducted in Shiraz, Southern Iran. Multistage and proportional to size random sampling were used. Different items about satisfaction and dissatisfaction toward urban family physician program were queried. Single variable and then multiple variable analyses of data were done using SPSS software (Chicago, IL. USA).

Results:

Mean age of 1257 participants in the study was 38.1 ± 13.2 years. Respondents included men (634; 50.4%), married (882; 70.2%), those who were educated at universities (529; 42%) and self-employed groups (405; 32.2%). One thousand fifty-eight (84.1%) were covered by the family physician program. Mean of referral times to a family physician was 2.2 ± 2.9 during the year before the study. Satisfaction toward urban family physician program was high in 198 (15.8%), moderate in 394 (31.3%), and low in 391 (31.1%). Dissatisfaction about this program was more among younger than 51-year-old groups (for 31–50 years odds ratio [OR] =2.3, 95% confidence interval [CI] =1.4–3.7, P < 0.001 and for 18–30 years OR = 2, 95% CI = 1.2–3.4, P = 0.005), less knowledgeable ones (OR = 2.2, 95% CI = 1.3–3.6, P = 0.001), singles (OR = 2.1, 95% CI = 1.2–3.4, P = 0.003), and those with more than 4 of family members (OR = 1.3, 95% CI = 1–1.7, P = 0.05).

Conclusions:

Overall, the majority of the people are not very satisfied with the urban family physician program. This shows the need for a multi-disciplinary approach including training, improvement of infrastructures and referral system, continuous supervision, and frequent monitoring of user's and provider's feedback about this program. According the results, the family physician program should be improved prior to extending this program to other provinces in Iran.