Family doctor contract services (FDCS) are a central component of primary care reform in mainland China. FDCS is a policy-based primary care service model in which residents enrol with a family doctor-led primary care team to receive coordinated, continuous, and population-oriented healthcare services. However, the outcomes used to evaluate FDCS are highly heterogeneous across empirical studies and programme evaluations, with substantial misalignment between policy-mandated indicators and outcomes reported in research. At present, there is no agreed core outcome set (COS) for evaluating FDCS in China.
This study aims to develop a COS for evaluative studies and programme evaluations of FDCS in mainland China. The scope of this COS is restricted to outcomes reflecting the intended effects and value of FDCS. Structural indicators, process indicators, and implementation metrics are outside the scope, because the purpose of this study is not to develop a full structure–process–outcome performance framework, but to identify a minimum set of core outcomes that should be measured and reported consistently in FDCS evaluation studies.
Candidate outcomes have been identified through a prior scoping review and will be prioritised through a multistakeholder consensus process, including Delphi surveys and a final consensus meeting. Key stakeholder groups include contracted residents, family doctors and other primary care team members, managers, policymakers, and researchers.
A search of the COMET database identified potentially relevant work, including the “Development of a Core Outcome Set for Family and Community Nursing (FCN-COS)”. This study is relevant in a broad sense because it addresses outcome standardisation in community-based care. However, it focuses on family and community nursing and outcomes sensitive to nursing interventions, rather than on FDCS as a policy-driven primary care service model in mainland China. Therefore, although related COS studies may provide useful conceptual or methodological reference, they do not directly address the scope, service model, or policy context of FDCS evaluation in China. A new COS is therefore needed.
Principal Investigator: Yang Wang, Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
Hua Jin, Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
Jose M Valderas, Department of Family Medicine and Singapore Primary Care Cancer Network (SPRiNT), National University Health System, Singapore
Dehua Yu, Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
Disease Category: Effective practice/health systems
Disease Name: Family doctor contract services
Age Range: 18 - 100
Sex: Either
Nature of Intervention: Other
- Clinical experts
- Consumers (patients)
- Governmental agencies
- Other
- Policy makers
- Researchers
- Service providers
- COS (Other)
- Consensus meeting
- Delphi process
- Interview
- Literature review
Candidate outcomes were identified through a prior scoping review of outcomes used in studies and evaluations of family doctor contract services (FDCS). The preliminary list of outcomes was refined and prioritised through a multistakeholder Delphi process involving contracted residents, family doctors and other primary care team members, managers, policymakers, and researchers. A final consensus meeting will be held to agree the core outcome set. The COS is intended for evaluative studies and programme evaluations of FDCS in mainland China.