关键词: 家庭医生签约服务, 社区卫生服务, 家庭医生

Abstract: Background　As a platform for the government to provide basic medical and public health services to the people，the efficient and orderly service of community health service centers will improve the operational efficiency of family doctors' contracted services and meet the basic health needs of residents.Objective　To analyze the difference between the expected value and the actual value of contracted services among residents in Datuan Community Health Service Center，and understand the operation status of the Center，so as to put forward countermeasures against existing problems.Methods　Contracting residents of Datuan Community Health Service Center were selected from April to June 2017 using a simple random sampling method.Self-designed Survey on the Evaluation of Expectations and Actual Values of Community Health Services by Contracting Residents were used during face-to-face interviews with contracting residents.The questionnaire consisted of 25 entries in 3 dimensions.Dimension 1 was the evaluation of 4 projects：visiting environment，service attitude，doctor's diagnosis and treatment skills，and construction of auxiliary functional platform of the health service center（including expected and actual values）；dimension 2 was the evaluation of environment，service attitude，diagnostic and therapeutic skills in different departments （actual value）；dimension 3 was the evaluation of operational service items，clinical laboratory items，radiation/echocardiography/electrocardiogram examinations，and drug supply（actual values）．Results　A total of 400 questionnaires were distributed，396 were recovered，and 390 valid questionnaires were collected，with an effective recovery rate of 97.50%.Among 390 contracted residents，206（52.82%）indicated that they concerned“doctors' diagnosis and treatment skills” the most，75 （19.23%）indicated that they focused on the“construction of auxiliary functional platform”.Visiting environment's expectation score was（8.34±1.27） points，actual value score was（8.23±1.34） points，service attitude expectation score was （8.49±1.17） points，the actual value score was （8.22±1.29） points，doctor's diagnosis and treatment skills expectation score was （8.59±1.06） points，and actual value score was （8.14±1.24） points，auxiliary function platform expectation score was （8.25±1.27） points，and actual value score was （7.97±1.33） points.Contracted residents evaluated the departments and top three highest actual value departments were general practice clinic〔（8.42±1.25） points〕，outpatient lobby〔（8.37±1.23） points〕，and outpatient department of Traditional Chinese Medicine〔（8.28±1.32） points〕.The actual value of doctors' operational service items in the community health service center was （7.95±1.40） points；clinical laboratory items was （7.92±1.33） points；radiation/echocardiography/electrocardiogram examinations items was（8.01±1.23） points；drug supply was （7.66±1.38） points.209（53.59%）contracting residents thought that there was an urgent need to improve the“drug supply”.Ninety-eight （27.22%）thought it was urgent to improve“perational service items”.Conclusion　Contracting residents are most concerned about the diagnosis and treatment skills of doctors in community health service centers.The gap between the expected value and the actual value is large.The evaluation of doctors' operation items is low，and the supply of drugs can not meet the demand.Under the guidance of the government，we suggest to establish Family Doctor Studio，introduce internal competition mechanism，change performance appraisal standards，and speed up the construction of talent team.Through the“system+science and technology” management model，the function of community health service centers can be improved.

Key words: Family doctors contract service, Community health services, Family doctor