Abstract
Background
Family physician–contracted service (FPCs) has been recently implemented in Chinese primary care settings. This study was aimed at measuring the effects of FPCs on residents’ health-related quality of life (HRQoL) and equity in health among the Chinese population.
Methods
The study data was drawn from the 2018 household health survey (Shaanxi Province, China) using multistage, stratified cluster random sampling. We measured HRQoL using EQ-5D-3L based on the Chinese-specific time trade-off values set. Coarsened exact matching (CEM) technique was used to control for confounding factors between residents with and without a contracted family physician. The concentration index (C) was calculated to measure equity in health.
Results
Individuals with a contracted family physician had significantly higher HRQoL than those without, after data matching (0.9355, 95% CI: 0.9302–0.9409 vs. 0.8995, 95% CI: 0.8926–0.9063; P < 0.001). Additionally, the inequity in HRQoL among respondents with a contracted family physician was significantly lower than those without a contracted FP (Cs of EQ-5D utility score: 0.0084, 95% CI: 0.0047–0.0122 vs. 0.0263, 95% CI: 0.0187–0.0340; p < 0.001).
Conclusions
This study highlights the positive effects of FPCs on HRQoL and socioeconomic-related equity in HRQoL. Future efforts should prioritize the economically and educationally disadvantaged groups, the expansion of service coverage, and the competency of family physician teams to further enhance health outcome and equity in health.
Leveraging Health-Related Quality of Life in Population Health Management: The Case for Healthy Days