Association between family doctor contract services and management status among patients with hypertension or diabetes in a multi-ethnic Province of China

The family doctor contract service has emerged as a crucial model for managing chronic diseases. This study aims to examine the association between family doctor service contract and follow-up management and control among patients with hypertension and diabetes in a remote multi-ethnic province of China. A cross-sectional study was conducted using data from the 2023 Hainan Health Service Survey. After excluding samples with missing values, 2686 adult participants with hypertension or diabetes were included in the analysis. A logistic regression model was employed to examine the association between contracted family doctor services and both management and control. Subgroup analyses were also performed based on race and region. Among the respondents, 66.34% had contracted a family doctor. The rates for follow-up management, drug therapy, and disease control were 54.06%, 65.86%, and 60.16%, respectively. Patients who contracted a family doctor exhibited significantly better outcomes in follow-up management (OR=5.49, P<0.001) and disease control (OR=1.39, P<0.001), but no significant association was found with drug therapy (OR=1.13, P=0.202). Patients of Han ethnicity demonstrated higher rates of drug therapy adherence (OR=2.54, P<0.001) and disease control (OR=1.98, P<0.001) compared to ethnic minority patients. Rural patients also showed better disease control rates than urban patients (OR=1.25, P=0.015). Family doctor contracted services play an important role in improving follow-up management and disease control for patients with hypertension and diabetes. There are significant differences in follow-up management and disease control among different ethnic groups and regions. The findings highlight the need to consider cultural, lifestyle, and medical factors in promoting family doctor services for personalized interventions.