Influencing factors of decision-making for diabetic patients to choose family doctors as providers of chronic disease management services

Objective To investigate the current situation of diabetes management in community, to clarify the decision-making factors of patients choosing family doctors as disease management service providers, and to provide suggestions for the implementation of family doctors' contracted services. Methods In May 2018, a simple random sampling method was used to select 500 diabetes patients diagnosed in a community in Shanghai. The questionnaire was designed by ourselves. With Likert's 5-level scoring method, 30 items from 7 dimensions were used to investigate the decision-making influencing factors of patients choosing family doctors as disease management providers, and 22 items from 6 dimensions were used to investigate that of patients not choosing family doctors. Results For 500 patients who met the inclusion criteria, the five items that had the greatest impact on the selection of family doctors as disease management service providers were as follows:good service attitude(mean value of influencing factors evaluation is 1.17); family members are easy to accompany and take care of(mean value is 1.15); doctors are familiar with and understand the situation of patients(mean value is 1.08); chronic diseases are stable(mean value is 1.07); close to home, easy to use(mean 1.06). Among the factors that didn't choose family doctors, the top five items that had the greatest influence were as follows:not providing expert outpatient service(the average value of influencing factor evaluation is 0.96); worrying that one visit can't solve the problem(the average value is 0.87); no significant change in the proportion of medical insurance payment(the average value is 0.80); reimbursement policy does not specify preferred community(the average value is 0.77); community medical equipment can't meet the demand(the average value is 0.76). Conclusion Due to the advantages of distance and time, low cost and good service, family doctor service is the main factor for residents to choose providers of chronic disease management services. However, medical technology, equipment, drug supply and current health policy factors still have certain constraints on residents to choose family doctors to provide chronic disease management services preferentially.