Mechanisms Affecting the Effectiveness of Contracted Family Doctor Services: a Grounded Theory Analysis

Background It is urgent to improve the effectiveness of contracted family doctor services due to high prevalence of problems such as uninformed contracting, and contracting but making no appointments. Objective To analyze the mechanism influencing the effectiveness of contracted family doctor services. Methods From September 2021 to January 2022, in-depth interviews were conducted with 24 family doctors, 8 institutional managers, and 25 contracted residents purposively sampled from Weifang, Heze, and Jinan of Shandong Province, using an interview guide regarding implementation status of relevant policies and their work status, performance distribution and supervision and management, and sense of gain obtained from the contracting and desired services, respectively. The grounded theory using three levels of coding was used to systematically analyze the mechanism affecting the effectiveness of contracted family doctor services. Results Through the coding, 90 concepts (such as "residents' weak health awareness")