Analysis on the Effect of Family Doctor Contraction on Residents' Medical Expenses

doi:10.7664/CHE20180512

Abstract：Objective:To explore the effect of the signing on relief residents’ medical burden by analyzing out-of-pocket medical expense which could most intuitively be perceived by residents.Methods:Collecting data of residents from Changning District (Shanghai Synergism Reform Pilot) by following questionnaire survey.Results:Out of pocket(OOP) medical expense of contracted residents was much higher than the uncontracted,but such difference disappeared after age structure and disease status were controlled;model test showed that the annual OOP medical expense of contracted residents in 2016 was lower than those of unsigned residents by 593.6 yuan,while the contracted residents' expense in 2013 was still higher.In terms of the influencing factors of cognition,behavior and chronic disease services,knowing the location of community health service center and selecting medical institutions for medical treatment were both significant,through which family doctor affecting the medical expense.But chronic disease services had not yet played a role.Conclusion:The age and disease structure led to the illusion that contracted residents had higher medical costs.The management and control of medical expenses,based on family doctors and medical insurance reform,highly relied on the effective implementation of health management,in which still had a long way to go.