Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 20:16:2171-2185.
doi: 10.2147/RMHP.S428369. eCollection 2023.

Construction and Scale Development of Willingness to Utilize Primary Care Services: A Study from China

Ziyang Li  1 , Zhiqiang Ma  1
Affiliations

Construction and Scale Development of Willingness to Utilize Primary Care Services: A Study from China

Ziyang Li et al. Risk Manag Healthc Policy. .

Abstract

Purpose: The willingness to utilize primary care services is crucial in explaining residents' healthcare-seeking behavior and decision-making in the context of the free choice of healthcare providers. This study examines China's family doctor contracting services system to elucidate the conceptual structure of the willingness to utilize primary care services and develop a reliable measurement tool.

Methods: The study was conducted in two phases. Firstly, in-depth interviews were conducted with community residents, resulting in 42 qualitative data sets. Subsequently, a measurement scale for the willingness to utilize family doctor contracting services was developed, and the scale was validated through two surveys using exploratory factor analysis (N = 250) and confirmatory factor analysis (N = 278), respectively.

Results: By employing a grounded theory approach, this study analyzes the connotation of willingness to utilize family doctor contracting services. It constructs a conceptual framework for the willingness to utilize primary care services. This conceptual framework consists of three dimensions: perceived feasibility, perceived desirability, and perceived initiative. Based on this framework, a measurement scale comprising 14 items was developed and subjected to rigorous validation procedures to ensure its reliability and validity.

Conclusion: This study extends prior research on healthcare service utilization willingness by elucidating the internal willingness structure for primary healthcare services. It enhances our understanding of the connotation of healthcare service utilization willingness and develops a scientifically rigorous measurement tool. The findings of this study provide valuable insights into improving both the willingness and behavior of utilizing primary care services in healthcare systems where the hierarchical referral system still needs to be fully developed.

Keywords: family doctor contracting services; grounded theory; primary care utilization willingness; scale development.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Conceptual structure of residents’ willingness to utilize family doctor contracting services.
See this image and copyright information in PMC

References

    1. Liu Y, Kong Q, Yuan S, van de Klundert J, Ciccozzi M. Factors influencing choice of health system access level in China: a systematic review. PLoS One. 2018;13(8):e0201887. doi:10.1371/journal.pone.0201887 - DOI - PMC - PubMed
    1. Notice on Issuing the Guiding Opinions on Promoting Family Doctor Contract Services. Available from: http://www.gov.cn/gongbao/content/2016/content_5124373.htm. Accessed May 15, 2023.
    1. Zhang Y, Su T, Chai Q, et al. Analysis of the status quo of policies on contracted family doctor services in Taiyuan based on in-depth interview. Chin General Pract. 2020;23(4):468–472. doi:10.12114/j.issn.1007-9572.2020.00.053 - DOI
    1. National Medical Service Status from January to November; 2022. Available from: http://www.nhc.gov.cn/mohwsbwstjxxzx/s7967/202304/60a495626bec4ec58cd746.... Accessed June 9, 2023.
    1. Fishbein M, Ajzen I. Belief, Attitude, Intention, and Behavior: an Introduction to Theory and Research. Philosop Rhetoric. 1977;10(2):130–132.