The Design of Family Doctor Contract Service Packages for Primary and Secondary School Students in Beijing postprint

Abstract: Background  The health of primary and secondary school students in China faces many challenges. Against the policy background of the state strengthening physical health management and promoting family doctor contract services, it is imperative to extend family doctor contract services to functional communities such as schools. Objective  Research on the design of family doctor contract service package suitable for the characteristics of Beijing from the perspective of grass roots medical and health institutions and schools, and provide for promoting the work of family doctor contract service in functional communities such as schools. Methods Using convenient sampling method, 62 participants, including heads of family doctor teams from community healthcare services and school doctors from primary and secondary schools in seven districts of Beijing were selected for a questionnaire survey in August 2024. The survey included the basic information of the respondents, assessing the necessity of basic health service package and four types of personalized service packages (vision, nutrition, oral, and psychological), covering service necessity, implementation feasibility, and recommendation rates. Results The overall recommended proportions of the basic health service package and four types of personalized health service packages were 83.5% (518/620), 74.2% (414/558), 72.2% (358/496), 66.6% (372/558), and 70.0% (304/434), respectively. Among them, the recommended proportions of services such as establishing and updating health records and vaccination services, visual health education and intervention services, nutritional counseling and guidance services, establishing student oral records service items, and establishing student mental health records services were relatively high, at 93.5% (58/62), 93.5% (58/62), 91.9% (57/62), 83.8% (52/62), 83.8% (52/62), and 77.4% (48/62), respectively. The recommended proportions of services such as carrying out self-filling screening scales for psychological problem screening, discovering common eye diseases such as conjunctivitis, nutritional therapy services, root canal therapy services, appropriate technologies such as psychological relief were relatively low, at 75.8% (47/62), 56.5% (35/62), 53.2% (33/62), 53.2% (33/62), and 59.7% (37/62), respectively. Apart from the necessity and feasibility of the Basic Health Service Package, the evaluations of the family doctor contract services for primary and secondary school students showed statistically significant differences between primary healthcare institutions and school medical professionals (P<0.01). Conclusion  Basic health services, as well as personalized health record management, health education and intervention, and nutrition consultation and guidance services are key contents of the family doctor contract service package for primary and secondary school students in Beijing. The diagnosis and treatment service items are also necessary, but the items should selected and included in the contract service package according to the actual diagnosis and treatment capacity of the grass-roots medical and health institutions.