Fuzzy-set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergencies

ObjectiveBy studying the Technology-Organization-Environment Framework (TOE), this research explores the impact of various indicators in technology, organization, and environment on the performance of family doctor services during major public health emergencies. It aims to identify the driving path...

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Main Authors: Gan Wang, Li Luo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1565499/full
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author Gan Wang
Gan Wang
Li Luo
Li Luo
author_facet Gan Wang
Gan Wang
Li Luo
Li Luo
author_sort Gan Wang
collection DOAJ
description ObjectiveBy studying the Technology-Organization-Environment Framework (TOE), this research explores the impact of various indicators in technology, organization, and environment on the performance of family doctor services during major public health emergencies. It aims to identify the driving paths to improve performance.MethodsA stratified sampling of 34 community health service centers in Shanghai was conducted, using the comprehensive performance score of family doctors as the outcome variable. The Average Internet Medical Service Person-times and the Information Technology Expenditure per Thousand Population were considered as technology-related variables. The Fiscal Allocation per Thousand Population (/1,000), the Family Doctor Team Members per Thousand Population, and the Medical Social Workers and Volunteers per Thousand Population were identified as organization-related variables. The Proportion of Older Adult Population, Fiscal Allocation per Thousand Population, and the number of patient self-education organizations per thousand population were taken as environment-related variables. Fuzzy-set Qualitative Comparative Analysis (fsQCA) was employed to conduct necessity analysis, truth table analysis, and configurational analysis of antecedent conditions, with robustness tests performed by adjusting consistency thresholds and case frequencies.ResultsThe study found that the performance of family doctor services was influenced by multiple factors, with no single decisive factor. In overall communities, five configurations, including per capita fiscal allocation and community participation, affected performance, explaining 4.2% of the variance. In central urban areas, information technology expenditure and the Proportion of Older Adult Population were core conditions, influencing 27.5% of performance paths. In non-central urban areas, core conditions such as financial support and IT covered 53.9% of data cases. The fsQCA results, which were robustly tested, begin to provide a strong basis for resource allocation and policy formulation.ConclusionThis study begins to fill the gap in research on family doctor service performance during major public health emergencies, exploring the synergistic effects and causal asymmetry among multiple indicators such as technology, organization, and environment from a holistic, or configurational, perspective.
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spelling doaj-art-bfa253eaefa240b3ab0014f11a53f0dd2025-08-20T03:17:01ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-04-011310.3389/fpubh.2025.15654991565499Fuzzy-set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergenciesGan Wang0Gan Wang1Li Luo2Li Luo3Shanghai Institute of Infectious Diseases and Biosecurity, Fudan University, Shanghai, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaShanghai Institute of Infectious Diseases and Biosecurity, Fudan University, Shanghai, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaObjectiveBy studying the Technology-Organization-Environment Framework (TOE), this research explores the impact of various indicators in technology, organization, and environment on the performance of family doctor services during major public health emergencies. It aims to identify the driving paths to improve performance.MethodsA stratified sampling of 34 community health service centers in Shanghai was conducted, using the comprehensive performance score of family doctors as the outcome variable. The Average Internet Medical Service Person-times and the Information Technology Expenditure per Thousand Population were considered as technology-related variables. The Fiscal Allocation per Thousand Population (/1,000), the Family Doctor Team Members per Thousand Population, and the Medical Social Workers and Volunteers per Thousand Population were identified as organization-related variables. The Proportion of Older Adult Population, Fiscal Allocation per Thousand Population, and the number of patient self-education organizations per thousand population were taken as environment-related variables. Fuzzy-set Qualitative Comparative Analysis (fsQCA) was employed to conduct necessity analysis, truth table analysis, and configurational analysis of antecedent conditions, with robustness tests performed by adjusting consistency thresholds and case frequencies.ResultsThe study found that the performance of family doctor services was influenced by multiple factors, with no single decisive factor. In overall communities, five configurations, including per capita fiscal allocation and community participation, affected performance, explaining 4.2% of the variance. In central urban areas, information technology expenditure and the Proportion of Older Adult Population were core conditions, influencing 27.5% of performance paths. In non-central urban areas, core conditions such as financial support and IT covered 53.9% of data cases. The fsQCA results, which were robustly tested, begin to provide a strong basis for resource allocation and policy formulation.ConclusionThis study begins to fill the gap in research on family doctor service performance during major public health emergencies, exploring the synergistic effects and causal asymmetry among multiple indicators such as technology, organization, and environment from a holistic, or configurational, perspective.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1565499/fullfamily doctorservice performancemajor public health emergenciesfsQCAinfluencing factors
spellingShingle Gan Wang
Gan Wang
Li Luo
Li Luo
Fuzzy-set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergencies
Frontiers in Public Health
family doctor
service performance
major public health emergencies
fsQCA
influencing factors
title Fuzzy-set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergencies
title_full Fuzzy-set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergencies
title_fullStr Fuzzy-set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergencies
title_full_unstemmed Fuzzy-set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergencies
title_short Fuzzy-set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergencies
title_sort fuzzy set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergencies
topic family doctor
service performance
major public health emergencies
fsQCA
influencing factors
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1565499/full
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