Intervention effect of family doctor service approach among community chronic disease patients

Objective To explore the effect of family doctor service approach on disease management, quality of life and medical expenses among community patients with chronic diseases. Methods By using stratified sampling, 1 200 chronic diseases patients registered in 10 community health centers affiliated to Futian District Institute of Chronic Disease Prevention and Control of Shenzhen municipality were enrolled in the study in January 2015.Then the patients were randomly assigned into an observation group and a control group;the patients of observation group signed an agreement with family doctors for the implementation of family doctor service approach and those of control received routine community intervention only.At the beginning and by the end of one year intervention, the status of disease management, medical cost and social support were assessed and the quality of life was evaluated with World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF)among the patients of observation and control groups. Results Compared to those of the control group, the patients of observation group showed significantly higher integrity rate of medical records (91.8% vs.82.0%), average score for medication compliance (14.2±1.3 vs.10.8±3.2), and all domain scores for social support(P < 0.05 for all)at the end of intervention;the patients of observation group also reported significantly higher scores for all domains of WHOQOL-BREF and lower annual medical expense (2 357.8±215.8 vs.3 556.8±287.5 RMB yuan)(both P < 0.05). Conclusion The family doctor service approach is helpful to improve disease management and quality of life and to reduce medication cost among community chronic disease patients.