The preferences of general practitioners regarding family physician contract in the underprivileged areas of Iran in using conjoint analysis

Sima   Rafiei; Rafat  Mohebbifar; Mohammad   Ranjbar; Fatemeh  Akbarirad

doi:10.18502/jebhpme.v3i2.1216

Sima Rafiei
Rafat Mohebbifar
Mohammad Ranjbar
Fatemeh Akbarirad

DOI: https://doi.org/10.18502/jebhpme.v3i2.1216

Keywords: General practitioner, family physician, logistic model, conjoint analysis

Abstract

Background: One of the most important methods for improving the fair access of people to health services is the family physician program, which is facing many challenges. One of these challenges is the lack of policymakers' understanding of physicians' preferences regarding the provisions of the family physician contract. Therefore, this study was aimed to investigate general practitioners' preferences regarding the type of family doctor contract in one of the underprivileged regions of Iran.

Methods: An analytical-cross-sectional study was conducted among 150 general practitioners (GPs) who registered in Ministry of Health and Medical Education (MoHME) family physician plan and were working in the health network of deprived regions in Iran. A discrete choice experiment (DCE) questionnaire was developed by the researchers and then distributed to GPs. Results were analyzed using Ordered Logistic Regression.

Data were collected using a questionnaire designed by orthogonal method in SPSS 20. Data analysis was performed using logistic regression model in Stata 13 software.

Results: Findings revealed that “type of employer” had the most significant effect on GPs’ preferences (OR = 2.5), followed by “allocating quota for admission to medical specialty courses after 5 years” (OR = 2.25), being allowed to give medical services to population without geographical restriction (OR = 2.8), being allowed to provide services out of the defined service packet (OR = 1.4), and “decreased length of contract” (OR = 0.93).

Conclusion: The amendment of the provisions of the family physician contract in accordance with physicians' preferences increases the probability of their participation in and compliance with the family physician program.

However, the compliance of the provisions of this contract with relevant international standards and upstream laws of the country should be maintained as much as possible.