SEARCHCROSS-SECTIONALpublic health, epidemiology

cross-sectional·public health, epidemiology, geriatrics, family medicine, observational study·PMC10255286

Barriers and facilitators of family doctor contract services in caring for disabled older adults in Beijing, China: a mixed methods study

BMJ Open · 9 authors, 6 centres

AI SUMMARY

FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

Quantitative data from 276 family doctors and qualitative data from 30 interviews were collected.

Full summary

648 CHARS

Quantitative data from 276 family doctors and qualitative data from 30 interviews were collected. Key findings include the identification of five unique roles for family doctors: psychological consultant, rehabilitation physiotherapist, health educator, health manager, and family health guardian. The most common service provided was primary care, while medication guidance was the most desired service. Significant differences in perceived role importance (p<0.001) and service satisfaction (p=0.004) were found among four districts. The study suggests the need to address these barriers to improve service quality for this vulnerable population.

STUDY TYPE

cross-sectional

SPECIALTY

public health

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10255286

Barriers and facilitators of family doctor contract services in caring for disabled older adults in Beijing, China: a mixed methods study

BMJ Open

READ THE FULL PAPER

ABSTRACT

Abstract Objective To evaluate the current state of family doctor contract services (FDCS) in Beijing, identify the roles of family doctors who have worked with disabled older adults and investigate the barriers and facilitators faced by family doctors in providing care for them. Design A convergent mixed methods study was carried out from October 2020 to January 2021 to collect and analyse both quantitative and qualitative data. The integration strategies in this study were connecting the results of the quantitative phase to data collection of the qualitative phase. Setting A multi-stage sampling strategy was used to select 15 community health centres (CHCs) in four districts of Beijing. Of the four districts, two were from urban areas and two were from rural areas. Participants The inclusion criteria for participants were (1) family doctors, (2) contracted with disabled older adults, (3) engaged in related work for disabled older adults more than 6 months. Methods A cluster sampling of 283 family doctors was used in the questionnaire. A purposive sample of 30 family doctors from the same CHCs was selected during the same period. Frequency and rank, rank-sum test, Kruskal-Wallis test were conducted in qualitative data analysis, the views of the interviewees were analysed through the thematic framework method. Results Currently, family doctors provided various services to satisfy the health needs of disabled older adults, while the usage of FDCS for disabled older adults is affected by many factors. The differences of the importance of family doctors’ role (p<0.001) and service satisfaction (p=0.004) were significant among four districts. Compared with contracted health senior citizens, this study has identified five unique roles of family doctors, including ‘psychological consultant’, ‘rehabilitation physiotherapist’, ‘health educator’, ‘health manager’ and ‘family health guardian’. Moreover, family doctors are confronted with a myriad of barriers (including high risks in the process of home visits, a lack of supervisory and incentive mechanisms, insufficiency of time and energy, etc) and facilitators (including establishing a doctor–patient trust relationship, developing humanistic care services, etc) in the FDCS for disabled older adults. Conclusions Family doctors play a pivotal role in the FDCS for disabled older adults, while the effect and quality of FDCS in China needs to be improved. It is suggested that further research needs to focus on solving existing barriers of FDCS to optimise the health of disabled older adults and improve the quality of their lives. Keywords: quality in health care, health services administration & management, organisation of health services, health services for the aged

CITATION EXPORT

Zhiying Zhang, Ruyi Zhang, Yingchun Peng et al.. Barriers and facilitators of family doctor contract services in caring for disabled older adults in Beijing, China: a mixed methods study. BMJ Open. (2023). https://doi.org/10.1136/bmjopen-2022-070130

AUTHORS

9 · 6 CENTRES

Zhiying Zhang, Ruyi Zhang, Yingchun Peng, Shaoqi Zhai, Jiaying Zhang, Qilin Jin, Jiaojiao Zhou, Hanlin Li, Jingjing Chen

1 School of Medical Humanities, Capital Medical University, Beijing, China
2 Ethics Committee Office, Beijing Ditan Hospital, Capital Medical University, Beijing, China
3 Cardiac Surgery Department, People’s Hospital of Beijing Daxing District, Beijing, China
4 Medical Department, Fengtai District Xiluoyuan Community Health Service Center, Beijing, China
5 School of Basic Medical Science, Capital Medical University, Beijing, China
6 Administrative Office, Huairou District Liulimiao Community Health Service Center, Beijing, China