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Table 2 Descriptive characteristics of the studies included in the review

From: Can social capital play a role in contracting services of family doctors in China? Reflections based on an integrative review

Title, Author, publication year and country Study aim Design Sample strategy and sample size Data collection method Analytical approach Strengths and /Limitations Key findings reported by authors
Factors influencing patients’ contract choice with general practitioners in shanghai: a preliminary study
[20]
CHINA
To analyze the main influencing factors of contract behavior, including the concept of social capital, and put forward some suggestions for further development of the GP system of health care A cross-sectional survey A random sampling of 1200 patients Questionnaire Descriptive and t-test, χ2 test, factor analysis, and logistic regression analysis were used to analyze the data The main limitation of this study was that just one district was studied in Shanghai The influencing factors of patients' contract behavior were age (OR = 1.03; 95% CI = 1.02–1.04), education (OR = 0.83; 95% CI = 0.75–0.93), social interaction of social capital (OR = 1.34; 95% CI = 1.15–1.56), acceptance of first contact in community (OR = 3.25; 95% CI = 2.07–5.12), year of investigation (OR = 2.58; 95% CI = 1.92–3.47), and exposure to the public (OR = 1.60; 95% CI = 1.39–1.85)
Social capital and frequent attenders in general practice: a register-based cohort study
[26]
Denmark
To explore the association between frequent attendance and individual social capital Based on a cohort study survey The sampling for participants used a municipality stratified random sampling strategy and in total 35,700 residents, above the age of 16, were sampled from 579,000 inhabitants in 11 municipalities The survey was distributed in a paper by mail in February 2010, and both paper and online responses were possible Descriptive and multiple logistic regression analysis This study was conducted explicitly at the individual level, whereas previous literature has featured multilevel or area-level analyses, which might influence the findings Frequent attendance was associated with lower scores (adjusted for age, education, and income) in women's interpersonal trust (OR 0.86 (0.79 – 0.94)) and social networking (OR 0.88 (0.79 – 0.98)). There was no significant relationship between reciprocal norms and citizen participation and frequent attendance of women (1.05 (0.99–1.11) and 1.01 (0.92–1.11), respectively. These associations were not statistically significant for men
Social networks and the probability of having a regular family doctor
[10]
Canada
To examine the role played by social supports in helping to explain why a significant portion of the Canadian population does not have a regular family doctor even though primary care is fully covered by the public insurer and when having a regular physician is associated with better care and with access to specialists Cross-Sectional Five Canadian Community Health Surveys spanning 2001 to 2010 (n = 13,872 to n = 30,814) Extraction of data from a community survey estimated coefficients from a probit model Continuing to develop ways of quantifying social supports and incorporating them into longitudinal surveys would help facilitate empirical analyses on how social supports affect health- care utilization There was evidence that there is a positive link between social support, especially a sense of belonging and the presence of regular doctors
Social capital and having a regular family doctor: Evidence from longitudinal data,
[1]
Canada
to examine the impact of social capital (e.g., tangible support, friends, and family) on having a regular family doctor taking into account that social capital may be endogenously determined longitudinal survey data the Canadian National Population Health longitudinal survey (1994–2010: n = 41,022) the Canadian National Population Health longitudinal survey (1994–2010) dynamic random effects probit model Since past access to a family doctor is a strong predictor of both current and future access, we show that social capital is much more important in helping individuals find a family doctor than for keeping one There was evidence that there is a statistically significant positive causal relationship between social capital and the possibility of having regular family doctors
Social support, flexible resources, and health care navigation,
[15]
USA
To examine how social support operates as a flexible resource that helps people navigate the health care system Qualitative study design The study combines in-depth interviews with parents of pediatric cancer patients (N = 80), direct observation of clinical interactions between families and physicians (N = 73), and in-depth interviews with pediatric oncologists (N = 8) Interview and observational methods Descriptive and qualitative data analysis software NVivo 8 Results from this study improve understanding of the mechanisms that underlie the development and deployment of strategies for navigating the health care system and highlight the role of social support as a flexible resource that helps people meet institutional expectations for appropriate involvement in health care The results show that doctors evaluate parents' visibility in hospital, medical vigilance and adherence to children's treatment, and use these judgments to form clinical decisions. Parents who get help from personal networks are more flexible in balancing competing needs, which enables parents to more effectively meet the agency's expectations of parents' proper participation in child care
Residents’ Awareness of Family Doctor Contract Services, Status of Contract with a Family Doctor, and Contract Service Needs in Zhejiang Province, China: A Cross-Sectional Study,
[30]
CHINA
The aim of this study was to investigate the residents’ awareness of Zhejiang Province, China, of family doctor contract services, the status of signing such a contract, and the demand for service items in the contracted service package Cross-sectional Survey enrolled 3960 residents from nine counties in Zhejiang Province using a multistage stratified random sampling method self-designed questionnaire Descriptive and analytical. Data were analyzed by SPSS 21.0 On the one hand, this was a cross-sectional study using a multistage stratified random sampling method to select respondents. As we know, most young people go out to work and the elderly stay at home, which may lead to under-representation of the whole population in Zhejiang Province Health consultation (84.64%), regular physical examination (81.71%) and medical insurance reimbursement (80.06%) were the top three demands for contracted services. The awareness rate and signing rate of household doctors in Zhejiang Province are not ideal
General practitioners and carers: a questionnaire survey of attitudes, awareness of issues, barriers and enablers to the provision of services,
[16]
UK
to identify GPs’ attitudes, awareness of issues, and perceptions of the barriers and enablers to the provision of services Cross-sectional Survey Seventy-eight out of a total of 95 GPs self-completion questionnaire Descriptive and analytical The study had a high response rate. A limitation is that the study participants had mostly chosen to attend a workshop on carers and may have been an atypical group motivated to support carers General Practitioners consider time, resources and lack of knowledge as obstacles, but only 9% agreed that they can provide little support. However, 89% of the ten GPS (9) think they don't have enough training, and about half (47%) lack confidence
The influential role of personal advice networks on general practitioners’ performance: a social capital perspective,
[5]
Italy
The main goal of our study consists of assessing the influence of a GP’s social capital on her/his capacity to accomplish two organizational objectives related to his/her prescribing behaviour: containing health expenditures and fostering prescriptive standards cross-sectional data from one LHA of the Italian NHS Extracted data from the Italian National Health System, local health authorities (LHA) from 80 GPs’ A questionnaire was used for collecting data from archival sources of the Italian National Health System, local health authorities (LHA) from 80 GPs’ Descriptive and multivariate regression models Alternatively, qualitative in-depth analyses could better explain the micro-dynamics behind the findings from this study Social capital may affect the ability of a General Practitioner to achieve his/her goals. In particular, the higher the professional heterogeneity of the GP's personal counselling network, the lower his / her ability to achieve the specified appropriateness goals
Social relations and loneliness among older patients consulting their general practitioner,
[12]
Denmark
to analyze the social relations and loneliness of patients aged 65 years and above consulting their GP Cross-sectional survey Stratified sampling of Patients aged ≥ 65 years consulted their general practitioner in the study period in 12 practices in the Capital Region of Denmark (N = 459), Questionnaire Descriptive and analyzed using univariate logistic regression it is a limitation that we only included patients who are able to visit the practice and to fill out the questionnaire. By not including those receiving home visits, very old and frail patients are probably underrepresented, and they are most likely lonelier than the respondents used in this study 36.2% of the people have a high degree of social participation, 45.5% have a medium degree of social participation, 18.3% have a low degree of social participation, 17.9% often or occasionally feel lonely. Higher social participation was associated with lower loneliness. Only 15.2% of autistic patients asked their GPs about their loneliness
Family physician–patient relationship and frequent attendance of primary and specialist health care: Results from a German population-based cohort study, [11]
Germany
To investigate the association between the quality of the family physician–patient relationship and the frequent attendance of primary and specialist health care Cohort study design German population sample (N = 2266) Patient-Doctor Relationship Questionnaire Descriptive and multivariate analysis Besides several strengths, like the use of a large sample representative of the German population and the use of a validated measure of perceived family physician–patient relationship quality, the study has some limitations. The study could not access health care use data of the participants available at health insurance companies Frequent visits by family doctors were associated with lower income (OR 1.43, 95% CI 1.02–2.00), unpaid work (OR 1.58, CI 1.08–2.30), mental distress (OR 1.14, CI 1.07–1.22), physical symptoms (OR 1.07, CI 1.04–1.11), and comorbidity (OR 1.54, CI 1.36–1.74). Family doctors should be aware that demand factors, namely symptom burden and physical comorbidity, are the main drivers of frequent visits
No Spouse, No Son, No Daughter, No Kin in Contemporary China: Prevalence, Correlates, and Differences in Economic Support,
[40]
CHINA
To investigate the kin availability among adults aged 45 + in contemporary China, with an emphasis on child gender Cross-sectional survey data extraction nationally representative survey data from the China Health and Retirement Longitudinal Study (2011) With a multi-stage area probability sampling design Extracted secondary data from a national survey Descriptive and regression models analysis N/A In China, the proportion of people without relatives is very low (less than 2% of them do not have spouses/partners and children), but the availability of relatives is determined by gender, age group and socio-demographic characteristics. The proportion of the elderly without spouse/partner and daughter (3.2%) was more than twice that of the elderly without spouse/partner and son (1.4%). Adults without close relatives are disadvantaged in terms of health, wealth and financial support
Understanding the Association Between Perceived Financial Well‑Being and Life Satisfaction Among Older Adults: Does Social Capital Play a Role?
[39]
USA
The study examined the association between perceived financial well-being and life satisfaction while focusing on a potential mechanism, that is, whether or not social capital mediated the relationship between these two important factors in the lives of older adults A longitudinal study of 2014 Health and Retirement Study (HRS) 4682 older adults (between the ages of 51 and 104) were included in the study sample This study utilized data extracted from the 2014 Health and Retirement Study (HRS) Descriptive and inferential analysis e.g. t-tests and F-tests were conducted and Ordinary Least Square (OLS) regression models were for the analysis of data A study that will utilize more accurate variables that capture the bridging social capital would be desirable Social capital plays a significant role in the relationship between financial well-being and life satisfaction of the elderly