In order to promote the hierarchical diagnosis and treatment system and the construction of healthy China, the General Office of the State Council clearly pointed out that a medical community should be established in the county. Zhejiang Province took the lead in exploring the integrated outpatient service of chronic diseases in the construction of medical community. At present, the research on the integrated outpatient service of chronic diseases in China mainly focuses on the discussion of concepts, and less quantitative research is carried out on the current situation of services.

To analyze the current situation of the integrated outpatient service of chronic diseases in county medical communities in Zhejiang Province and explore its influencing factors, so as to provide countermeasures and suggestions for improving the operation of the integrated outpatient service of chronic diseases.

From October to November 2023, using the typical sampling method and taking into account the principle of geographical balance, 18 community health service centers/township hospitals under 6 medical communities in Linping District of Hangzhou, Yuhuan City of Taizhou, Jiangshan City of Quzhou and Jiashan County of Jiaxing in Zhejiang Province were selected, and outpatients were intercepted at the outpatient waiting offices of corresponding institutions as the research objects. A self-designed questionnaire was used to investigate the patients' evaluation of integrated outpatient services for chronic diseases. The evaluation content involved three aspects: service category, service approach and team building.

A total of 540 questionnaires were distributed and 510 valid questionnaires were recovered, with an effective recovery rate of 94.4 %. The overall score of patients' integrated outpatient service for chronic diseases was (4.4±0.5) points, and the scores of each service category were: pre-diagnosis service (4.4±0.5) points, in-diagnosis service (4.3±0.5) points, and post-diagnosis service (4.1±0.6) points. The average score of each item in the service approach dimension was ≥3.7 points, and the average score of each item in the service team building dimension was ≥3.9 points. The results of multiple linear regression analysis showed that factors such as age, education, monthly income, whether the overall medical services of the hospital could meet their own needs, and satisfaction with the hospital 's diagnosis and treatment environment would have an impact on the evaluation of the development of integrated outpatient clinics for chronic diseases (P<0.05) .

The current situation of integrated outpatient services for chronic diseases in county medical communities in Zhejiang Province is generally good, but there is still room for improvement in post-diagnosis services, service channels, and overall medical services. The primary medical and health institutions in Zhejiang Province should pay attention to the continuity of post-treatment services, strengthen the integrated outpatient service mode and team building of chronic diseases, promote the development of medical services in a diversified and high-quality direction, and enhance the residents' sense of medical experience.