Difficulties and Solutions for the Family Doctor Team in Preventing and Managing Public Health Emergencies: a Study Using the Value Chain Approach

Background: Currently, the family doctor team still faces many obstacles in managing public health emergencies as the gatekeeper. However, there is little research on the difficulties of family doctor teams in the prevention and management of public health emergencies. Objective: To explore the difficulties of family doctor teams in the prevention and management of public health emergencies, providing a theoretical basis and recommendations on ensuring the highly efficient performance of family doctor teams in preventing and managing the emergencies. Methods: Convenience sampling was used to select frontline healthcare workers from 25 primary healthcare institutions of Guangzhou to complete an online survey using a self-administered questionnaire conducted in June 2020 for investigating the implementation of essential public health services, essential medical services and prevention and management of public health emergencies in their hospitals between February and June 2020. Interviews were conducted with some of the healthcare workers who volunteered to be interviewed. Results: According to the questionnaire survey, during February to June 2020, of the 25 institutions, 19 had halted the delivery of some or all essential public health services, 6 had no capacities and channels to transfer suspected or confirmed COVID-19 cases to designated COVID-19 hospitals, 24 had implemented the emergency response plan for the COVID-19 pandemic, 10 had offered COVID-19-related health education, 9 had not set up the infectious diseases and public health emergencies reporting and managing system, 10 had not established the fever clinic, and 11 had operated all the clinics as usual. Value chain analysis of the interviews indicated that difficulties faced by the family doctor team in preventing and managing public health emergencies were: insufficient in-hospital support, unsuccessful communication and collaboration between hospitals or between the hospital and other institutions, poor monitoring and early warning effect of the COVID-19 pandemic, insufficient COVID-19-related health education, residents' unmet needs of essential medical services, inadequate emergency response infrastructure, lack of public health professionals, discrepancy between the construction of various information systems, inappropriate emergency procurement system. Conclusion: To make the community a solid fortress for the prevention and management of public health emergencies to ensure residents' health and safety, the authors suggest that efforts shall be made to address the barriers to the implementation of essential medical services first, then to solve issues existing in the implementation of auxiliary services. Copyright © 2021 by the Chinese General Practice.