What matters most in family doctor teams? Preference evidence from community residents and primary healthcare providers

Background Family doctor contract services (FDCS) are a key strategy to strengthen primary healthcare systems in China. Understanding preferences for the design of family doctor teams is essential for optimising health workforce performance and service delivery. This study aimed to elicit and compare the preferences of community residents and primary healthcare providers (PHPs) regarding key attributes of FDCS. Methods Two discrete choice experiments (DCEs) were conducted, one for community residents and the other for PHPs. Attributes and levels were established using qualitative methods. There were six attributes for community residents and PHPs, with most attributes differing between the two groups, except for FDCS composition. Data were analysed using mixed logit models. Results A total of 1,110 community residents and 1,298 PHPs completed a discrete choice experiment questionnaire, resulting in effective response rate of 77.08% and 81.38%, respectively. The most significant factors influencing community residents’ FDCS preferences were advanced competence ( β = 1.948, p < 0.001) and good friendliness ( β = 1.939, p < 0.001) of the family doctor team. In contrast, PHPs placed the greatest emphasis on good coordination ( β = 3.494, p < 0.001) and regular composition ( β = 3.438, p < 0.001) of the family doctor team. Improvements of the these attributes of FDCS would result in a notable increase in the uptake rates of both community residents and PHPs. Conclusions This is the first study employing two DCEs to comprehensively reveal the preferences of community residents and PHPs regarding the use of FDCS in urban communities of China. To advance the design and implementation of the FDCS, it is essential to consider three key aspects: the differentiated construction of family doctor teams, improvement of service experience, and development of supportive measures. It has the potential to contribute to the development of FDCS in China and other developing countries with similar primary healthcare systems.