关键词: 家庭医生签约服务, 分级诊疗, 基层医疗卫生机构, 签而不约

Abstract: Despite the progress in contracted family doctor services（CFDSs） has been made in recent years，there still exist contracts with little consumption，which affects the implementation of the hierarchical medical system.We analyzed the reasons of residents signing the contract with family doctors but not making an appointment from a supply-demand perspective，which include the following：supply-side factors：family doctors are in serious shortage and underpaid，the implementation of the CFDSs lacks of corresponding supports as well as reasonable assessment mechanism；demand-side factors：residents lack of a good knowledge of the CFDSs and distrust the capabilities of family doctors，and medical insurance policies have underplayed their role in guiding health-seeking behaviors of residents properly.Therefore，we proposed the following recommendations：making the general practice as a career be more attractive，expanding the workforce and improving the capabilities of general practitioners；advancing the attractiveness of the CFDSs，and formulating the service standards and procedures；Giving full play to the lever role of medical insurance in promoting the development of the CFDSs；intensifying the publicity of the CFDSs.

Key words: Contracted family doctors services, Hierarchical medical system, Grassroots medical institutions, Singing without appointment