Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Measures
2.3. Data Collection
2.4. Statistical Analysis
2.5. Ethical Statement
3. Results
3.1. Sample Characteristics
3.2. Factors Influencing the GP Contract Service Demand of the Elderly
3.3. Factors Influencing the GP Contract Service Signing Decision of the Elderly
4. Discussion
5. Limitations
6. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Characteristics | Signed with a GP | GP Contract Service Demand | ||||||
---|---|---|---|---|---|---|---|---|
Yes (n = 816) | No (n = 624) | Total (n = 1440) | p Value | Yes (n = 797) | No/Uncertain (n = 643) | Total (n = 1440) | p Value | |
Sex, % | 0.09 | 0.72 | ||||||
Male | 41.18 | 36.70 | 39.24 | 39.65 | 38.72 | 39.24 | ||
Female | 58.82 | 63.30 | 60.76 | 60.35 | 61.28 | 60.76 | ||
Age group, % | 0.03 | 0.02 | ||||||
60– | 36.03 | 41.03 | 38.19 | 35.88 | 41.06 | 38.19 | ||
70– | 40.20 | 39.26 | 39.79 | 40.28 | 39.19 | 39.79 | ||
80– | 23.77 | 19.71 | 22.01 | 23.84 | 19.75 | 22.01 | ||
Caregiver, % | <0.001 | 0.10 | ||||||
Spouse | 54.78 | 66.35 | 59.79 | 58.09 | 61.90 | 59.79 | ||
(Grand)children | 28.43 | 23.40 | 26.25 | 27.35 | 24.88 | 26.25 | ||
Others (e.g., community worker) | 3.19 | 2.56 | 2.92 | 3.76 | 1.87 | 2.92 | ||
None | 13.60 | 7.69 | 11.04 | 10.79 | 11.35 | 11.04 | ||
Chronic disease history, % | 0.58 | 0.41 | ||||||
Yes | 83.95 | 82.85 | 83.47 | 84.19 | 82.58 | 83.47 | ||
No | 16.05 | 17.15 | 16.53 | 15.81 | 17.42 | 16.53 | ||
Diabetes or cardiovascular disease history, % | 0.03 | 0.04 | ||||||
Yes | 71.08 | 65.54 | 68.68 | 70.89 | 65.94 | 68.68 | ||
No | 28.92 | 34.46 | 31.32 | 29.11 | 34.06 | 31.32 | ||
Self-evaluated health status, % | 0.58 | 0.35 | ||||||
Very good | 28.94 | 27.17 | 28.17 | 29.04 | 27.10 | 28.17 | ||
Good | 49.69 | 52.09 | 50.74 | 50.19 | 51.40 | 50.74 | ||
Bad | 20.62 | 18.97 | 19.90 | 20.00 | 19.78 | 19.90 | ||
Very bad | 0.75 | 1.77 | 1.19 | 0.76 | 1.71 | 1.19 | ||
Medical insurance, % | <0.001 | <0.001 | ||||||
UEBMI | 35.17 | 57.69 | 44.93 | 35.88 | 56.14 | 44.93 | ||
URBMI | 63.60 | 41.51 | 54.03 | 62.99 | 42.92 | 54.03 | ||
Others | 1.23 | 0.80 | 1.04 | 1.13 | 0.93 | 1.04 | ||
Average personal income per month, % | <0.001 | <0.001 | ||||||
≤RMB 1000 | 29.90 | 17.79 | 24.65 | 30.61 | 17.26 | 24.65 | ||
RMB 1001–3000 | 50.49 | 44.07 | 47.71 | 46.80 | 48.83 | 47.71 | ||
RMB 3001–5000 | 14.83 | 31.89 | 22.22 | 16.69 | 29.08 | 22.22 | ||
≥RMB 5001 | 4.78 | 6.25 | 5.42 | 5.90 | 4.82 | 5.42 |
Influence Factor | Univariate | Multivariable c | ||
---|---|---|---|---|
Odds Ratio (95% CI) | p Value | Odds Ratio (95% CI) | p Value | |
Sex | ||||
Male | 1.00 (reference) | - | - | |
Female | 0.96 (0.78–1.19) | 0.72 | - | - |
Age group | ||||
60– | 1.00 (reference) | - | - | |
70– | 1.18 (0.93–1.49) | 0.18 | - | - |
80– | 1.38 (1.04–1.83) | 0.02 | - | - |
Caregiver | ||||
Spouse | 1.00 (reference) | - | - | |
(Grand)children | 1.17 (0.92–1.50) | 0.20 | - | - |
Others (e.g., community worker) | 2.15 (1.09–4.25) | 0.03 | - | - |
Nobody | 1.01 (0.72–1.42) | 0.94 | - | - |
Chronic diseases history a | ||||
No | 1.00 (reference) | - | - | |
Yes | 1.12 (0.85–1.48) | 0.41 | - | - |
Diabetes or cardiovascular disease history b | ||||
No | 1.00 (reference) | 1.00 (reference) | ||
Yes | 1.26 (1.01–1.57) | 0.04 | 1.33 (1.05–1.68) | 0.02 |
Self-evaluated health status | ||||
Very bad | 1.00 (reference) | - | - | |
Bad | 2.27 (0.82–6.30) | 0.12 | - | - |
Good | 2.19 (0.80–5.98) | 0.13 | - | - |
Very good | 2.40 (0.87–6.62) | 0.09 | - | - |
Medical insurance c | - | - | ||
UEBMI | 1.00 (reference) | 1.00 (reference) | ||
URBMI | 2.30 (1.85–2.84) | <0.001 | 1.96 (1.46–2.61) | <0.001 |
Average personal income per month (USD$:RMB¥ = 1:6.9) | ||||
≤RMB 1000 | 1.00 (reference) | 1.00 (reference) | ||
RMB 1001–3000 | 0.54 (0.41–0.71) | <0.001 | 0.67 (0.50–0.90) | 0.01 |
RMB 3001–5000 | 0.32 (0.24–0.44) | <0.001 | 0.59 (0.39–0.90) | 0.01 |
≥RMB 5001 | 0.69 (0.42–1.14) | 0.15 | 1.19 (0.67–2.13) | 0.55 |
Influence Factor | Univariate | Multivariable c | ||
---|---|---|---|---|
Odds Ratio (95% CI) | p Value | Odds Ratio (95% CI) | p Value | |
Sex | ||||
Male | 1.00 (reference) | 1.00 (reference) | - | |
Female | 0.83 (0.67–1.03) | 0.09 | 0.53 (0.40–0.71) | <0.001 |
Age group | ||||
60– | 1.00 (reference) | - | - | |
70– | 1.17 (0.92–1.48) | 0.20 | - | - |
80– | 1.37 (1.04–1.82) | 0.03 | - | - |
Caregiver | ||||
Spouse | 1.00 (reference) | 1.00 (reference) | - | |
(Grand)children | 1.47 (1.15–1.88) | <0.01 | 1.62 (1.19–2.22) | <0.01 |
Others (e.g., community worker) | 1.51 (0.80–2.85) | 0.21 | 0.84 (0.37–1.89) | 0.67 |
Nobody | 2.14 (1.49–3.08) | <0.001 | 3.08 (1.89–4.78) | <0.001 |
Chronic diseases history a | - | |||
No | 1.00 (reference) | - | - | |
Yes | 1.08 (0.82–1.43) | 0.58 | - | - |
Diabetes or cardiovascular disease history b | ||||
No | 1.00 (reference) | - | ||
Yes | 1.29 (1.03–1.62) | 0.03 | - | 0.02 |
Self-evaluated health status | - | |||
Very bad | 1.00 (reference) | - | ||
Bad | 2.58 (0.93–7.17) | 0.07 | - | - |
Good | 2.26 (0.83–6.19) | 0.11 | - | - |
Very good | 2.53 (0.92–6.97) | 0.07 | - | - |
Medical insurance c | - | - | ||
UEBMI | 1.00 (reference) | - | ||
URBMI | 2.51 (2.03–3.12) | <0.001 | - | <0.001 |
Average personal income per month (USD$:RMB¥ = 1:6.9) | - | |||
≤RMB 1000 | 1.00 (reference) | 1.00 (reference) | ||
RMB 1001–3000 | 0.68 (0.52–0.89) | 0.001 | 0.89 (0.64–1.24) | 0.49 |
RMB 3001–5000 | 0.28 (0.20–0.38) | <0.001 | 0.34 (0.23–0.51) | <0.001 |
≥RMB 5001 | 0.46 (0.28–0.75) | <0.001 | 0.39 (0.21–0.73) | <0.01 |
GP contract service demand | ||||
No | 1.00 (reference) | 1.00 (reference) | ||
Yes | 12.71 (9.88–16.34) | <0.001 | 13.20 (10.09–17.27) | <0.001 |
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Share and Cite
Zhao, Y.; Lin, J.; Qiu, Y.; Yang, Q.; Wang, X.; Shang, X.; Xu, X. Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China. Int. J. Environ. Res. Public Health 2017, 14, 356. https://doi.org/10.3390/ijerph14040356
Zhao Y, Lin J, Qiu Y, Yang Q, Wang X, Shang X, Xu X. Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China. International Journal of Environmental Research and Public Health. 2017; 14(4):356. https://doi.org/10.3390/ijerph14040356
Chicago/Turabian StyleZhao, Yanrong, Junfen Lin, Yinwei Qiu, Qing Yang, Xinyi Wang, Xiaopeng Shang, and Xiaoping Xu. 2017. "Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China" International Journal of Environmental Research and Public Health 14, no. 4: 356. https://doi.org/10.3390/ijerph14040356