Residents’ Awareness and Satisfaction of Family Doctor Services and Two-way Referral in Two Pilot Towns of Shaanxi Province

Abstract

Objective: To understand residents’ awareness and satisfaction of family doctor service and two-way referral through investigating their situation of visiting family doctors and demand for family doctor services in two pilot towns in Shaanxi Province.

Methods: Using the convenience sampling, local residents from Shengshui Town and Huangguan Town in Hanzhong City of Shaanxi Province were recruited according to the locations of investigators. Residents were interviewed face to face with a self-designed questionnaire from July to August of the year 2016. The main contents of the questionnaire were the baseline characteristics of residents, residents’ awareness of family doctor service and two-way referral, residents’ demand for family doctor services, ways they get information about family doctor services, residents’ situation of visiting family doctors and asking for the two-way referral, residents’ satisfaction of family doctor services, and residents’ evaluation of the two-way referral. A total of 300 questionnaires were distributed and 225 effective questionnaires were collected. The effective recovery rate was 75.0%.

Results: There were 91.1% (205/225) of the residents who knew the family doctor services and two-way referral. Top three service projects with the highest awareness rate were annual free medical examination[83.6% (188/225)], the establishment and management of health records[56.0% (126/225)] and reimbursement ratio of two-way referral[53.8% (121/225)]. There were significant differences among residents with different age, occupation and self-health status in residents’ awareness rate of the family doctor services and two-way referral (P＜0.05). And 72.9% (164/225) of residents believed that the current service projects of family doctors could meet their basic needs. The service project with the highest demand rate[81.3% (183/225)] was regular medical examination, and the main way the residents got information about family doctor services[36.0% (81/225)] was the introduction of medical staff. In addition, 89.3% (201/225) of the residents were in favor of initial diagnosis in primary health care institutions, and 86.2% (194/225) of the residents preferred to visit doctors in primary health care institutions. The most satisfying service project was service attitude. Moreover, 18.2% (41/225) of the residents were satisfied with the service attitude very much, and 66.2% (149/225) of the residents were satisfied with the service attitude. The residents who thought the referral to superior hospitals from the primary health care institutions was carried out in a more timely manner accounted for 21.3% (48/225), and 70.7% (159/225) of the residents thought the referral to superior hospitals was carried out in time. The residents who thought the superior hospitals took more timely action on the referral accounted for 22.7% (51/225), and 62.6% (141/225) of the residents thought the superior hospitals took action on the referral timely.

Conclusion: The residents’ awareness and satisfaction of the family doctor services and two-way referral are both in a high level. Family doctor services and two-way referral plays an important role in increasing the initial diagnosis rate in primary health care institutions and relieving the treatment pressure of large hospitals, which makes it deserve to be promoted in the future.