For building a healthy China, it is essential to expand the coverage of family doctor services. In young and middle-aged office building occupants, the rate of contracting family doctor services is low. Shanghai has taken the lead in exploring building-based family doctor services, and providing on-demand health management services. So it is particularly meaningful to study the health needs in young and middle-aged office building occupants.
To investigate the needs and associated factors of contracted family doctor services among young and middle-aged office building occupants in Shanghai.
A questionnaire survey was conducted from December 2019 to December 2020 with a cluster random sample of young and middle-aged office building occupants (aged 18-59 years) selected from representative office buildings in Shanghai's Hongkou District, Pudong New District, and Jing'an District of Shanghai for understanding their sociodemographic characteristics, health and healthcare-seeking conditions, knowledge of family doctor services, and needs of essential and personalized family doctor services. Multiple Logistic regression analysis was used to analyze the factors affecting the needs of family doctor services.
In all, 2 366 cases attended the survey, and 2 272 of them (96.03%) who completed the survey effectively were included for analysis. Among them, 87.65% (1 874/2 138) had general, moderate or strong needs for essential family doctor services, and 70.59% (1 452/2 057) had needs for personalized family doctor services. Multiple Logistic regression analysis indicated that age, education level, self-assessed social class, understanding of one's own health, self-assessed health status, chronic disease prevalence, mental health status, preferred healthcare setting for treating common diseases, treatment experience in a community health institution, understanding of and degree of trust in a family doctor, and understanding of building-based family doctor services and the specific scope of the services were associated with the needs of essential family doctor services (P<0.05). Education level, social health insurance, commonly used drugs, chronic disease prevalence, preferred healthcare setting for treating common diseases, treatment experience in a community health institution, understanding of building-based family doctor services, and understanding of the scope of building-based family doctor services were associated with the needs of personalized family doctor services (P<0.05) .
The contracted family doctor services were in high demand in young and middle-aged office building occupants. Improving health literacy in this population, modifying publicity strategies regarding the services, and improving the capabilities of the family doctor team and primary medical institutions, may be conducive to increasing the rate of contracting family doctor services in this group.
Shanghai is gradually expanding the supply of family doctor contract service to building functional communities, but the prevalence of met needs of such services in young and middle-aged office building occupants is still unknown, and relevant studies on the prevalence and associated factors could inform the development and improvement of policies regarding building-based family doctor services.
To explore the prevalence of met needs for contracted family doctor services and associated factors in young and middle-aged office building occupants.
A questionnaire survey was implemented from December 2019 to December 2020 in the setting of office buildings selected by typical sampling from Hongkou District, Pudong New District and Jing'an District of Shanghai. Among the young and middle-aged occupants (n=2 272, 18-59 years old) selected from the buildings by use of cluster random sampling to attend the survey, 1 137 with an experience of using contracted family doctor services were determined as the participants. The survey involved four aspects, including sociodemographic and economic characteristics, health status, understanding level of contracted family doctor services, and met needs of these services (containing essential and personalized service needs assessed using a 5-point Likert scale). Multinomial and ordinal Logistic regression was used to analyze factors associated with met needs of contracted family doctor services.
The prevalence of having needs of essential family doctor services considerably/completely met was 39.61% (425/1 073). And that of having needs of personalized family doctor services considerably/completely met was 39.01% (419/1 074). Multinomial and ordinal Logistic regression analysis revealed that registered place of household (Shanghai or not), occupation, annual income, self-rated health, understanding of the "1+1+1" type of contracted family doctor services, level of trust in family doctors, and evaluation of family doctors' service capabilities were associated with met needs of essential family doctor services (P<0.05). Sex, annual income, chronic disease prevalence, understanding of the "1+1+1" type of contracted family doctor services and the composition of a family doctor team, as well as evaluation of family doctors' service capabilities were associated with met needs of personalized family doctor services (P<0.05) .
The prevalence of self-reported met needs of essential or personalized family doctor services in the young and middle-aged office building occupants was about 40%, which was associated with sociodemographic and economic characteristics, health status, understanding level of contracted family doctor services, and self-assessed family doctors' service capabilities. It is recommended to improve the publicity of the system of contracting family doctor services, customize personalized service plans according to the characteristics and differentiated needs of the population, improve the family doctor's service capabilities and enrich the services.
The prevalence of sub-health problems is increasing in young and middle-aged office building occupants, in which the percentage of mental health problems is on the rise. Shanghai took the lead in delivering family doctor services via the health station set in an office building in June 2018, but mental health in young and middle-aged people has not yet been insufficiently covered by the services.
To assess the prevalence of anxiety and influencing factors in young and middle-aged office building occupants in Shanghai.
A questionnaire survey for estimating anxiety prevalence was carried out in typically sampled office buildings from Hongkou District, Pudong New District and Jing'an District of Shanghai during December 2019 to December 2020. Cluster random sampling was used to sample young and middle-aged occupants (18-59 years old) in the buildings, and 2 198 cases of them who completed the survey were included as the participants for analysis. Anxiety was diagnosed by the score of the Zung's Self-Rating Anxiety Scale. Multiple linear regression was used to estimate the association of anxiety prevalence with socio-demographic and economic characteristics, and health status as well as lifestyle.
Among the participants, the prevalence of no anxiety, mild, moderate and severe anxiety was 60.42% (1 328/2 198), 18.61% (409/2 198), 12.46% (274/2 198), and 8.51% (187/2 198), respectively. Multiple linear regression analysis found that registered place of household (Shanghai or not), education level, self-rated social class, self-rated health, frequency of physical examination, level of fatigue, chronic disease prevalence and regular medication were associated with anxiety prevalence (P<0.05) .
The prevalence of anxiety was high in this group of population, which may be associated with the population characteristics. In view of this, mental health should be valued during the delivery of family doctor services for these people, and targeted interventions can be provided according to personal anxiety status when necessary.
