The Current Status of the Quality of Family Doctor Contract Services Based on General Practitioners' Perspectives: a Semi-structured Interview Study

Background Family doctor contract services (FDCS) is an important measure for deepening medical reform in China, aimed at improving people's health level and the efficiency of the health service system. FDCS has achieved rapid development in terms of quantity, but there is currently a lack of research evidence related to the quality of FDCS. Objective To understand the current status and existing problems of home medicine service quality in Beijing from the perspective of general practitioners, and provide reference for improving the quality of FDCS. Methods Eighteen general practitioners from 18 community health service institutions in 9 districts of Beijing were selected through purposive sampling from August 2023 to June 2024, and semi-structured interviews were conducted with general practitioners based on the structure process outcome framework interview outline. Analyze the data through thematic analysis and extract interview themes. Results The study extracted 3 themes and 11 sub-themes. Theme 1: The structural quality of FDCS (policy guidance and implementation, institutional conditions and facilities, assessment and incentive mechanisms for FDCS, home healthcare team building). Theme 2: Process quality of FDCS (contract service content, referral and treatment service process, outpatient service standards). Theme 3: The effectiveness of FDCS (improvement in residents' health levels, increased willingness to seek medical treatment, need to strengthen residents' recognition of home medicine services, increased occupational pressure on general practitioners). Conclusion Since the implementation of home medical services, the quality of services has gradually improved, but there are still some limiting factors. We should strengthen policy support, optimize service content and processes, integrate quality evaluation systems with incentive mechanisms, enhance the comprehensive service capabilities of general practitioners and establish efficient home medical teams.