Q.W.J.C. [2023] No. 7

Notice on Issuing the Implementation Plan for Promoting High-Quality Development of Family Doctor Contract Services in Hainan Province by

Hainan Provincial Health Commission

Department of Finance of Hainan Province

Department of Human Resources and Social Security of Hainan Province

Hainan Provincial Healthcare Security Administration

and

Hainan Social Insurance Service Center

To the health commissions, the finance bureaus, the human resources and social security bureaus, the healthcare security administrations, the social insurance service centers of all cities, counties, and autonomous counties; as well as all affiliated hospitals of Hainan Medical University; and relevant units directly under the commission:

To implement the Guiding Opinions on Promoting the High-Quality Development of Family Doctor Contract Services jointly issued by the National Health Commission and five other government departments, the Provincial Health Commission, the Provincial Finance Department, the Provincial Human Resources and Social Security Department, the Provincial Healthcare Security Administration, and the Hainan Social Insurance Service Center have jointly formulated the "Implementation Plan for Promoting High-Quality Development of Family Doctor Contract Services in Hainan Province". This document is hereby issued to you. Please implement the document according to your local conditions.

Problems encountered during the implementation shall be directly reported to the relevant departments.

The contact person for the Provincial Health Commission: Ji Haiying, 65388380;

The contact person for the Provincial Finance Department: Wang Zhuan, 68503206;

The contact person for the Provincial Human Resources and Social Security Department: Wang Mingzhen, 65375126;

The contact person for the Provincial Healthcare Security Administration: Hu Haiyan, 66262610;

The contact person for the Hainan Social Insurance Service Center: Dou Jianfeng, 65370675.

Hainan Provincial Health Commission

Department of Finance of Hainan Province

Department of Human Resources and Social Security of Hainan Province

Hainan Provincial Healthcare Security Administration

Hainan Social Insurance Service Center

July 27, 2023

Implementation Plan for Promoting the High-Quality Development of Family Doctor Contract Services in Hainan Province

In accordance with the Guiding Opinions on Promoting the High-Quality Development of Family Doctor Contract Services (G.W.J.C.F. [2022] No. 10) jointly issued by the National Health Commission and five other government departments, this implementation plan has been formulated to accelerate the high-quality development of the family doctor contract services in Hainan Province.

I. Main Objectives

Efforts will be made to guarantee service quality and ensure that people have a growing sense of fulfillment and satisfaction. There will be an increase in the coverage ratio of the services, and a family doctor system will be established with family doctors as the gatekeepers of people’s health. Based on the existing conditions in cities and counties across the province, the coverage ratio of the services will grow by 1 to 3 percentage points each year starting from 2024. By 2035, the coverage ratios for the entire population and key groups in the province will at least reach 75% and 85%, respectively, and over 90% of the covered residents will be satisfied.

II. Main Tasks

(1) Establishing a System of Contracted Family Doctors for Primary Care to Encourage Residents to Seek Medical Care in an Orderly Way

1. Adopting the family doctor registration system. Health commissions in various cities and counties are responsible for establishing a management system for family doctor registration, defining requirements for family doctor license, registration, tracking management, and disqualification. The public health divisions of community-level medical and health institutions are responsible for the centralized management of family doctors within their jurisdictions. They should openly recruit dedicated and highly skilled general practitioners, specialists, and rural doctors from medical institutions at all levels and of all types, register family doctors, and then file the records with the city or county health commission. Basic information about family doctors should be publicly disclosed to the residents within the jurisdiction, and residents are free to choose and sign contracts with the doctors.

2. Establishing family doctor offices. All community-level medical and health institutions should enhance the development of family doctor offices. In principle, these offices, prevention and control stations for chronic diseases, and health huts should achieve shared growth through collaboration, offering "one-stop" services including basic medical care, public healthcare, and health management. Encouragement should be given to integrate community grid management and functions of village (neighborhood) committees to develop family doctor offices in rural communities and urban neighborhoods. This should adopt fixed-location, fixed-personnel, and fixed-time approaches, promoting family doctors to provide regular services. Based on actual needs, community-level medical and health institutions are supported to set up family doctor offices in functional communities, including government agencies, schools, enterprises, public institutions, industrial parks, and commercial buildings.

3. Securing the responsibility of contracted doctors for primary care as the health gatekeeper. Their priority is to maintain the health of residents. They should ensure that the residents can reach them at any time and promptly fulfill duties such as consultation, primary care, reception, triage, referral, and health guidance. In principle, after a resident signs the contract about family doctor services, all their medical needs, including disease screening, clinical diagnosis and treatment, rehabilitation and follow-up, appointment and referral, and health management, should be coordinated and managed by their primary care physician. The two parties should establish a long-term and reliable relationship based on the service contract.

4. Guiding residents to sign contracts with primary care physicians at the community level. Residents referred by their primary care family physicians enjoy preferential services such as priority in consultation, examination, and hospitalization. Refining the service process of community-level medical and health institutions, we should enable residents to spend less time in queuing and waiting and to settle up at one stop, after integrating processes related to payment, including registration, diagnosis and treatment, testing, examination, and picking up medication.

5. Ensuring service management for covered residents at all stages. Family doctors should have a full knowledge of the health status of their covered residents. For a covered resident who does indeed need a referral, their family doctor should make suggestions, promptly arrange the patient, track the treatment process in the referred hospital, and ensure the follow-up services when the patient is referred back. Community-level medical and health institutions should establish a referral review mechanism, clearly define related conditions, procedures, and requirements, and strengthen the review of the rationality and compliance of referrals made by family doctors.

(2) Strengthening "Six Expansions" to Increase Service Supply

1. Expanding the types of family doctors to include specialists in addition to general practitioners. While general practitioners are the main force of family doctors, other types of clinicians (including specialists in internal medicine, surgery, obstetrics, pediatrics, and traditional Chinese medicine), rural doctors, and retired clinicians can also register as family doctors.

2. Expanding the range of the service providers to include secondary and tertiary hospitals in addition to community-level medical and health institutions. Efforts should be made to encourage and guide clinicians, both general practitioners and specialists, from secondary and tertiary hospitals within closely-cooperated medical consortia to join the family doctor team. Together with community-level medical and health institutions within related jurisdictions, they can enhance the service capacity and provide services through the institutions at the community level.

3. Expanding the types of service providers to include private medical and health institutions in addition to the public ones. While ensuring that family doctor contract services are provided by public medical and health institutions at all levels, we will motivate private institutions, including clinics, to provide these services. This aims to meet the residents' diverse and tailored needs for health services. We will adhere to the leading role of the government and give full play to the market mechanisms, and pave the way for socially-operated medical and health institutions to engage in contract services through government procurement of services and other methods.

4. Expanding the service providers who are eligible to sign contracts to include individuals in addition to teams. A family doctor can not only sign contracts individually, but also collaborate with others to provide the contract services as a team. Based on the actual needs of covered residents and the existing medical resources, it is essential to build family doctor teams rationally. For doctors signing contracts individually, there should be more business guidance and technical support, so as to ensure both teams and individuals play roles in contract services.

5. Expanding the available options of the contract term. The options should be various. Residents can sign contracts with a term ranging from 1 to 3 years. In principle, contracts are renewed annually, with the calendar year as the service period. We aim to ensure that the relationship between residents and family doctors is flexible, stable, and reliable.

6. Expanding the responsibilities of family doctors from just managing chronic diseases to managing both chronic and infectious diseases. Family doctors should not only perform health management for patients with chronic diseases such as hypertension and diabetes, but also enhance their capabilities to identify and manage infectious diseases, such as COVID-19, influenza, dengue fever, and hand-foot-and-mouth disease. Family doctors should provide health services for patients with infectious diseases, including those with hepatitis B, according to the Guidelines on Health Management and Services for Hepatitis B Patients (Trial).

(3) Offering More Services to Improve Public Satisfaction

1. Developing basic medical and health services and basic public health services in a coordinated way. A system has been established and improved to ensure that covered residents see family doctors at community-level medical and health institutions and are provided with basic public health services. Efforts should be made to develop a closed-loop mechanism for chronic disease contract services, which encompasses prevention, screening, treatment, and management. We should promote family doctor contract services with general practitioners as the mainstay, boost effective collaboration between general practitioners and specialists, and integrate treatment with prevention. Family doctors, based on the health status and service needs of covered residents, should strengthen health management through the "Seven-One Services," which includes creating a resident health record, signing an agreement, conducting a health assessment, devising a health management plan, setting a service schedule, providing a contact card/sheet/service manual, and promoting a health philosophy. Based on the service capabilities of township-level health centers and community health service stations as well as people’s needs, family doctor teams (or individuals) are encouraged to offer qualified services in accordance with related regulations, and to develop relevant service functions, such as rehabilitation, integrated eldercare services with medical care, hospice care, and AI-assisted diagnosis and treatment.

2. Long-term prescription services. Efforts should be made to implement policies such as the management of essential drug lists, and strengthen the consistency of the drug list between community-level medical and health institutions and secondary or higher-level hospitals. Extended prescription services are encouraged to better meet the basic medication needs of covered residents. According to relevant regulations on long-term prescription management, patients with chronic diseases in a stable condition may apply for long-term prescription services after evaluation by their family doctors. In principle, the duration of the prescriptions should not exceed 3 months. By 2025, long-term prescription services will cover all township-level health centers and community health service stations across the province.

3. Traditional Chinese medicine (TCM) services. The contract services should involve TCM, and contracted teams should have more medical personnel in TCM. Family doctor teams (or individuals) are encouraged to utilize TCM techniques, such as acupuncture, massage, cupping, and moxibustion; to provide TCM preventive treatment; and to give full play to the role of TCM in basic healthcare and preventive care.

4. Services including appointment, referral, and follow-up. Secondary and tertiary hospitals should allocate a certain percentage of medical resources, such as outpatient slots and hospital beds, to community-level medical and health institutions and family doctors in advance. Currently, leading hospitals in closely-cooperated medical consortia should release no less than 20% of specialist outpatient slots to community-level medical and health institutions 14 days in advance. This percentage should increase year after year, with the goal of reaching no less than 30% by 2025. Additionally, a certain percentage of testing and examination services as well as hospital beds should be made available in advance for family doctors' appointments. Leading hospitals should organize specialists to build teams with family doctors in a "1+N" model. For covered patients with chronic diseases, specialists should participate in face-to-face follow-up at least once a year, while receiving subsidies.

5. Health consultation services. According to the basic health conditions of covered residents, targeted health consultation services should be provided through various forms such as face-to-face meetings, phone calls, and social media platforms. These services encompass health assessment, guidance, education, disease prevention, appointment assistance, and psychological counseling. The goal is to foster a close relationship between the contracted parties, enhance mutual trust and interaction, and develop long-term and stable service relationships.

6. House call services. If individuals, such as the elderly with mobility issues or dementia and the disabled, do indeed have needs, house call services should be offered, including treatment, follow-up, rehabilitation, nursing, hospice care, health guidance, and home-based medical care. When creating a list of house call services, we should take policies, techniques, and medical safety into consideration. Additionally, we should improve related standards and regulations, enhance relevant quality supervision, and ensure healthcare safety. Based on regional conditions, family doctors may be provided with necessary medical supplies and transportation tools, and these resources can be managed and allocated by the family doctors themselves.

7. Tailored contract services. Community-level medical and health institutions or family doctor teams (or individuals) should, based on their service capabilities and residents' needs, provide tailored services in addition to the basic ones. This customization aims to make the services more targeted and inclusive, to fulfill the diverse healthcare needs of the residents, and to make covered residents feel more satisfied with the services.

(4) Refining Service Delivery for Better Performance

1. Improving the performance of contracted teams at the community level. Community-level family doctor teams are primarily composed of family doctors, nurses, public health physicians (including assistants), and other healthcare professionals. In regions with adequate resources, pharmacists, health managers, psychological counselors, and social workers (volunteers) should be involved in these teams. Leading hospitals within closely-cooperated medical consortia should assign physicians, including TCM doctors, to provide technical support and guidance at the community level. They should set up and improve the green channel for two-way referral with community-level institutions, and enable general practitioners or designated specialists to collaborate with family doctors for referral services. Additionally, there should be increasingly available slots and hospital beds for appointments and referrals made by the community-level institutions. It is necessary for the institutions at the community level to refine family doctor teams in terms of tasks, workflow, regulatory standards, and roles; and to conduct regular performance assessments.

2. Services jointly provided by multiple suppliers. Based on the grid-based development for closely-cooperated medical consortia, all cities and counties should divide up the work and assign a part to each leading hospital. We will channel high-quality medical resources down to the community level to improve the service capacities through various approaches, including paired assistance, joint development of departments, and incentives for talented and licensed physicians to work at the community level. Efforts should be made to provide one-stop services with both general practitioners and specialists for covered residents, and vigorously promote the "1+1+1model" (involving one community-level medical and health service institution, one secondary hospital, and one tertiary hospital). This model enhances collaboration between general practitioners and specialists, fosters the integration of treatment and prevention at the community level, and makes the services more consistent, coordinated, and comprehensive.

3. More flexible services. Based on the geographical span and the population to be served, it is important to define the responsibilities of contracted teams (or individuals) in a reasonable manner. To rationally establish an upper limit for the number of services, it is vital to consider factors, such as service capacities, workload, and population groups within the relevant jurisdiction. Residents are supported in signing service agreements on a household basis. These agreements should clearly define the rights and responsibilities of both parties and outline the list of services to be provided.

4. Emphasizing health management for key groups. Family doctors are expected to serve the priority patients, including elderly people, pregnant and perinatal women, children, people with disabilities, residents lifted out of poverty, members of special one-child families, patients with hypertension, diabetes, tuberculosis, hepatitis B, or severe mental disorders. These groups should be given priority in terms of signing contracts and receiving services. Based on the classification and grading system, it's important to ensure that the services are provided to all elderly individuals with underlying medical conditions. Efforts should be made to keep in touch with these contracted elderly individuals, to enhance relevant health management and monitoring, and to ensure that both the individuals and their family members can reach their family doctors promptly when needed. We should strive to ensure that all patients with chronic diseases and elderly individuals in need are contracted, such as those from households precariously escaping poverty, poverty-prone households, and households with sudden and severe difficulties.

5. Signing contracts online. We should enhance regional health information exchange and sharing, leveraging platforms such as the Hainan management information system for community-level medical and health service institutions; the Hainan integrated information system for medical treatment, medical insurance and medication; and the management information system for closely-cooperated medical consortia; as well as relevant WeChat mini-programs. Establishing a “two-card” system for electric contract records, we should provide covered residents with online services, including signing agreements, health consultations, follow-ups for patients with chronic diseases, two-way referrals, and making appointments with specialists at higher-level institutions or for medical examinations and hospital beds. Services recorded in the information system serve as crucial factors for assessing and evaluating the performance of family doctors. Additionally, efforts should be made to promote and adopt new technologies such as artificial intelligence.

6. Signing more contracts with functional communities. Utilizing healthcare resources within their jurisdictions in a coordinated way, All cities and counties are encouraged to sign contracts with functional communities, such as Party and government agencies, enterprises, public institutions, industrial parks, commercial buildings, schools, and nursing homes. In accordance with the needs of these functional communities, efforts should be made to establish systems for health examinations, assessments, and intervention; to conduct training on infectious disease prevention and control, healthy lifestyle practices, and first aid; and to provide services such as online medical consultations and internet-based healthcare.

(5) Enhancing Capabilities to Improve the Quality of Contract Services

1. Strengthening the family doctor training system. We should enhance standardized training for resident general practitioners, assistant general practitioners, job transfers, and medical students oriented to serving rural areas. Every effort should be made to promote the accreditation test for assistant general practitioners serving rural areas, and to expand the family doctor workforce. We should work to see the training become a regular practice with an emphasis on knowledge and skills, such as clinical diagnosis and treatment, health management, psychological counseling, rehabilitation therapy, nursing skills, medical nutrition, and appropriate techniques of TCM. This will improve family doctors' abilities to diagnose and treat commonly-seen and frequently-occurring diseases, and to prevent, manage, and treat chronic diseases.

2. Enhancing basic medical service capabilities. All cities and counties should take measures according to the "Service Capacity Standards for Township-Level Health Centers," "Service Capacity Standards for Community Health Service Stations," and "Service Capacity Standards for Village Clinics." They should divide up the work and assign a part to each institution, to encourage leading hospitals within closely-cooperated medical consortia to comprehensively establish joint outpatient clinics and collaborative wards with community-level medical and health institutions. By doing so, we will enhance service capabilities across the province, strengthen the supply of basic medical services at the community level, and promote the full coverage of basic medical services.

3. Improving the cooperation between general practitioners and specialists and enhancing the integration of treatment and prevention. All cities and counties should encourage secondary and tertiary hospitals to set up a guiding team for family doctor contract services, or to assign specialist physicians to participate in the services. This creates a "1+1+1"  model featuring three-level coordination, providing covered residents with one-stop services including prevention, management and treatment. Leveraging the technical advantages of specialist diagnosis and treatment in leading hospitals within closely-cooperated medical consortia, they should provide technical support for family doctor contract services in the region. Family doctors should integrate patient health management into their regular clinical work to enhance the synergy and coverage of the services.

4. Making the contract services smarter. Family doctors, with the support of big data analysis and artificial intelligence, have improved their capabilities for disease diagnosis and treatment. Based on the provincial health information platform and the Hainan integrated information system for medical treatment, medical insurance and medication, we have access to related data, such as individual electronic health records and electronic medical records. This enables family doctors to leverage information technologies such as mobile Internet and the Internet of Things (IoT) to provide hybrid online and offline services, and to expand the potential for and scope of family doctor services.

(6) Improving the Support Mechanism to Motivate Family Doctors

1. Reasonable contract service charges. Family doctor teams (or individuals) provide contract services to covered residents, and the service charges shall be collected on an annual basis according to the number of persons served and the rate bases. Cities and counties should reasonably determine rate bases for both basic service packages and tailored service packages based on the services family doctors provide. For medical services included in the service packages with clear charges, the fees can be charged based on the amount of services. Additionally, rate bases should cover the cost of management services included in the service packages, such as referrals and follow-ups. Basic service packages should encompass basic public health services, as well as common basic medical services such as appointments for referral, rehabilitation follow-up, instructions on drug use, emergency treatment, and first aid. Tailored service packages should be designed according to the capabilities of community-level medical and health institutions and contracted doctors, as well as individual needs. The services of tailored packages should be determined according to agreements, and a certain discount can be given on the overall charges collected by medical institutions in accordance with related rate bases. For services without clear charges, they should undergo the approval procedure for new medical services, be assigned codes, be included in the service package charges, and be registered with the provincial healthcare security administration. In principle, covered individuals, based on basic service packages, can only select one tailored service package as part of the contract services. For covered functional communities, the rate bases of the services should be determined through negotiating with medical institutions in accordance with the agreed services and service frequency, and be registered with the provincial healthcare security administration. Cities and counties may develop family doctor contract service packages, and related services include but are not limited to those set out in Attachment 1.

2. Defining the payment mechanism for service packages. Service charges will be jointly covered by China's medical insurance system, government expenditure on public medical services, and the covered individuals. For services included in the family doctor contract service packages, those that are available for medical insurance reimbursement should be paid by basic medical insurance funds in a coordinated manner. However, if residents receiving the services are not covered by medical insurance, they should pay the charges on their own. For diagnosis and treatment services included in tailored service packages, they should be paid according to the going rates of medical services and related policies on general outpatient service costs covered by the medical insurance system, and those that are available for medical insurance reimbursement should be paid by basic medical insurance funds or individuals covered by medical insurance. For medical insurance expenditure on family doctor contract services, we will separately formulate related evaluation and assessment mechanisms, as well as settlement procedures. Cities and counties are encouraged to use local fiscal resources to cover the portion of the service charges paid by individuals including members of special one-child families, people living in poverty, and licensed disabled people. We should include commercial insurance into the contract services, and expand the ways for funding and subsidies.

3. Improving the incentive mechanism for family doctor contract services. It is important to reasonably set the settlement standards for family doctor contract services. In principle, over 70% of the service charges should be used for the emolument allocation of the staff participating in the family doctor contract services. Medical institutions at and above the secondary level should give preferential treatment to physicians participating in the services when allocating the merit pay. For cities and counties with adequate fiscal resources, financial support should be provided to family doctor teams and physicians from medical institutions at and above the secondary level participating in contract services. Adhering to the plan for special-post general practitioners, we should motivate general practitioners to play vital roles in contract services through fully implementing related systems of incentive merit pay and allowances.

4. Playing the guiding role of basic medical insurance. We should explore budgeting for outpatient services provided by community-level medical and health institutions according to the number of patients, and encouraging the public to seek medical care at the community level. It is to explore budgeting the amount payable by the medical insurance fund for outpatient service charges under the "2+3" health service package for the community-level medical and health institution or the family doctor (team) according to the number of patients. After primary care is provided by their family doctors, covered residents may be eligible for referrals, and some of the referral cost will be borne by the community-level medical and health institution or the family doctor (team). To improve the surplus retention policy, we should ensure that surplus funds are used for incentive merit pay and the management of community-level medical and health institutions, motivating medical institutions at all levels to engage in two-way referrals. Refining differentiated payment policies for medical institutions at different levels, we should reasonably determine reimbursement differences between community-level medical and health institutions and medical institutions at and above the secondary level.

5. Reasonably adjusting prices for medical services at the community level. Improving the dynamic adjustment mechanism for medical service prices, we should give priority to services with tiered diagnosis and treatment as well as high technical labor value. It is necessary to gradually increase the prices for medical services with the characteristics of community-level medical and health institutions, such as home-based medical care and house calls, so as to support the sustainable development of community-level medical and health institutions.

Ⅲ Implementation

(1) Local Responsibilities. Taking on local responsibilities better, each city and county, in accordance with actual conditions, should promptly formulate specific implementation plans, and detail work objectives and measures. It is essential to enhance overall coordination, establish and improve support systems for family doctor contract services, and create a working mechanism featuring government-leading, multi-sector collaboration, community-level medical and health institutions as platforms, and various social resources involved. Leveraging the roles of village (community) public health committees, they should provide guidance for establishing a 'one-to-one' coordination mechanism between the village (community) public health committees and family doctors, assist family doctors in providing contract services within their jurisdictions, and ensure the implementation of all measures.

(2) Management Responsibilities. The health administrative departments at all levels should collaborate with relevant departments to strengthen the organization and management of family doctor contract services. They should clearly define the entry criteria for institutions and individuals providing family doctor contract services, and establish an exit mechanism. The relevant departments, such as finance and healthcare security, at all levels should, in accordance with their responsibilities, collaborate with the health administrative departments to enhance the supervision of family doctor contract services. Considering geographical and traffic conditions as well as the population to be served within their jurisdictions, community health service stations and township-level health centers should reasonably allocate the service areas to family doctors based on travel distances. In the context of grid-based management, medical institutions at the community level should ensure that family doctors define their service packages, tasks, workflow, regulatory standards, and roles; and conduct regular performance assessments.

（3）Assessment and Evaluation. The health administrative departments at all levels should collaborate with relevant departments to enhance the assessment and evaluation of family doctor contract services. Evaluation criteria should include the number of covered individuals, the proportion of key groups, renewal rates, health management performance, service quality, and satisfaction of covered residents. It is necessary to conduct regular assessments for community-level medical and health institutions and family doctors via information technologies and follow-ups. Assessment results should be directly linked to funding allocation and merit pay. The implementation of family doctor contract services should be included in the assessment and evaluation conducted by the health administrative departments at all levels for leading hospitals within closely-cooperated medical consortia, community-level medical and health institutions, and related institutions. Based on monitoring indicators of family doctor contract services in Hainan Province (Attachment 2), each city and county can determine specific assessment indicators and targets according to their local work progress and goals. Additionally, efforts should be made to value the role of public evaluation, expand evaluation channels, and encourage covered residents and representatives from all walks of life to participate in the regular assessments and performance evaluation. Relevant results should be disclosed to the public, and serve as an important basis for the performance evaluation of family doctor teams (or individuals) and a key reference for residents in selecting the teams (or individuals).

(4) Publicity and Guidance. Efforts should be made to publicize family doctor contract services, and to ensure that more residents can benefit from them. We should pay more attention to promoting the contract services and their significance, and make residents have rational expectations. it is crucial to identify cases of developing family doctor contract services in a high-quality and efficient way. These cases contribute to raising people’s awareness and fostering a social atmosphere that advances the development of family doctor contract services. Conducting activities to honor outstanding family doctor teams (or individuals), we should pay more attention to the exemplary family doctors with high-quality services and great recognition from the public, and project a positive image of family doctors who are dedicated to serving the people.

This plan will be executed on January 1, 2024.

Attachments: 

1. Reference Table of Services and Rate Bases of Family Doctor Contract Service Packages in Hainan Province

2. Monitoring Indicators of Family Doctor Contract Services in Hainan Province

3. Agreement on Family Doctor Contract Services in Hainan Province (Template)

4. Procedure for Family Doctor Contract Services in Hainan Province

5. Progress Report on Family Doctor Contract Services in Hainan Province