What do Iranian general practitioners expect from family physician contracts?

摘要

Family medicine has become a main prerequisite of providing primary healthcare and a main reforming strategy to ensure the delivery of efficient and high-quality health services. This study aimed to investigate general practitioners’ (GP) preferences regarding family physician contract. Cross-sectional study was conducted among GPs who registered in Ministry of Health and Medical Education (MoHME) family physician plan and were working in the health network of moderately developed regions in Iran. The sample size was calculated to be 150 GPs who were randomly selected from MoHME database. Developed questionnaire was distributed to GPs. Results were analysed by ordinal regression model. Study results confirmed that ‘type of employer’ had the most significant effect on GPs’ preferences (β=0.86). Then attributes including ‘allocating quota for being accepted in medical specialty’ (β=0.78), ‘increased length of contract’ (β=0.00.42) and ‘capitation payment+15% bonus’ had respectively the great effects on participants’ decision. Findings also revealed that a scenario of contracting with medical council was 2.4 times more likely to be chosen by GPs compared with a scenario of contracting with a medical university. Furthermore, a scenario that allocated a quota for admission to medical specialty courses was 2.18 times more probable to be preferred by them (p0.001). Successful implementation of family medicine requires development of suitable solutions for attracting and attaining GPs in the programme. It seems that using a variety of incentives and applying them in physicians’ work contract would be helpful in this regard.