PP404 Effect Evaluation Of Two Family Doctor Contracting Service Models On Diabetic Patients: A Real-World Study In Chengdu, China

IntroductionTo strengthen the care capacity of primary facilities, China has vigorously promoted the construction of a hierarchical medical system and a family doctor care system. In July 2017, a family doctor care plan was launched in an urban district of Chengdu, Sichuan Province, and two family doctor contracting service models were adopted, one provided a basic-service package and the other a paid-service package. In order to evaluate the effect of different models on diabetic patients, this study conducted a real world study based on the district healthcare database.MethodsDiabetic patients who contracted family doctor services January 2018 to January 2019 as reported in the database were enrolled in the paid- or basic-service group. Propensity score matching (PSM) was conducted to balance the distribution of covariances between the groups. The results of the first and last examination of glycosylated hemoglobin, low-density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure in the groups were compared by independent sample t-test and chi-square test.ResultsIncluded were 4,871 patients in basic-service and 394 patients in paid-service. In both groups the total control rates of blood pressure, glycosylated hemoglobin and LDL-C at the last physical examination were 43.67, 79.28 and 51.11 percent, respectively, a significant increase from pre-test. The combined control rates of HbAlc, LDL-C and blood pressure in the basic- and paid-service group were 20.76% and 22.37%, respectively. After PSM, there was no significant difference between the groups.ConclusionsUp to now, there is no significant difference between basic-service and paid-service family doctor contracting service models in improving the comprehensive control rate of diabetic patients. The possible reasons may be that the quality and content of paid-service is not as good as expected, the period of implementation is not long enough and the sample size of paid-service patients is limited.