The moderation effect of family doctor contract services on health expenditure and health-related quality of life among patients with chronic diseases

Health-related quality of life (HRQoL) encompasses individuals’ subjective health perceptions across physical functioning, psychological status, and social dimensions. In a new study published in Pharmacoeconomics and Policy, a team of researchers in China explores the relationship between catastrophic health expenditure (CHE) and HRQoL among patients with chronic diseases in China. Additionally, the team also looked at the potential benefits of family doctor contract services in reducing the negative effects of CHE.

“Using data from the 2023 Heilongjiang Health Service Survey, we employed Tobit regression and propensity score matching (PSM) to analyze the data,” shares first author Xiangjin Cui. “We found that households facing CHE had significantly lower HRQoL scores (0.743) compared to those without CHE (0.903).”

Notably, CHE was found to have a negative impact on HRQoL, but family doctor services were effective in mitigating this negative effect. Factors like older age, multiple chronic conditions, and high healthcare utilization were associated with lower HRQoL, while higher education and stable employment were protective factors.

“Our findings underscore the vicious cycle of poverty and deteriorating health caused by CHE, suggesting that family doctor contract services can reduce healthcare costs, improve disease management, and enhance overall HRQoL,” adds Cui.

The team recommends expanding such services, especially to vulnerable groups, and integrating them with healthcare insurance to alleviate financial burdens and improve health outcomes for chronic disease patients.

Contact author name: Xiangjin Cui, School of Health Management, Harbin Medical University, Harbin, China

Funder: The authors are grateful to the National Health Service Survey of Heilongjiang Province, China for providing the data. This research was supported by the National Natural Science Foundation of China (NSFC) General Project (Grant Nos.: 72274045, 71974048, and 7237041356). The authors sincerely thank all contributors for their valuable input and support throughout the research process.

Conflict of interest: The authors declare that there are no conflicts of interest.

See the article: https://doi.org/10.1016/j.pharp.2025.05.001