Abstract: Objective　To investigate the demographic characteristics，working status，job satisfaction，awareness of contracted family doctor services （CFDSs） and of the influencing factors for the delivery of such services among the members of community-based family doctor teams.Methods　This study was conducted using in-depth and key informant interviews about the barriers for the implementation of CFDSs with 30 members of family doctor teams and a survey with a self-developed questionnaire among 558 medical professionals delivering CFDSs from 14 community health centers located in three cities of Wuhan，Xiangyang and Yichang combined with a literature review.Results　Most（46.1%） of the 558 family doctor team members had junior college degree.The average monthly income was about 4 000 yuan for those from Yichang and Wuhan，but 2 355.8 yuan for those from Xiangyang.The median number of professional trainings per year was 6.50，2.00，2.00 times for those from Yichang，Wuhan，Xiangyang，respectively.61.3% of the participants showed a great interest in job，but only 39.8% of them showed satisfaction with the level of social recognition won by family doctor as an occupation，and only 35.5% of them presented satisfaction with the workload.Even worse，less than 41.0% of them were satisfied with the staffing of the team，office environment，and medical equipment allocation.Over 70% of the participants thought that poor propagation of CFDSs，high level of residential mobility，insufficient family doctors，inadequate residents' awareness of CFDSs，and heavy workload were the factors hindering the successful implementation of CFDSs.Conclusion　In order to better promote the delivery of CFDSs，the recruitment of and professional trainings about CFDSs for community health workers should be improved，the service performance of community health organizations should be advanced，the performance evaluation mechanisms for family doctors should be perfected，and the propagation of the policies related to CFDSs should be strengthened.

Key words: Family doctor, Signing service, Root cause analysis, Countermeasure

摘要： 目的　了解湖北省家庭医生团队成员的基本情况、工作情况及对家庭医生签约服务的认知、工作满意度，从家庭医生视角提出制度实施过程中的影响因素。方法　在文献研究的基础上，同时对30例家庭医生团队成员进行个人深入访谈，了解当前家庭医生签约服务实施障碍。自行设计问卷，对武汉、襄阳、宜昌3个城市的14家社区卫生中心的558例参与家庭医生签约服务的医务人员进行调查。结果　558位家庭医生团队成员中，学历以大专为主（46.1%）；宜昌市和武汉市家庭医生团队成员月均工资在4 000元左右，而襄阳市人员月均工资2 355.8元；宜昌市家庭医生团队成员1年内每人接受业务培训次数的中位数为6.50次，武汉市、襄阳市均为2.00次。满意度方面，调查对象对工作兴趣满意度为61.3%，而对于工作的社会认可度和工作量的满意度仅有39.8%、35.5%；对团队人员配备、办公条件和医疗设备配备的满意度低于41.0%。超70%的被调查者赞同宣传力度、居民流动性、人员数量、居民认知以及人员工作量为阻碍家庭医生签约服务开展的较大制约因素。结论　为促进家庭医生签约服务更好实施，应加大社区医务人员培养培训和引进力度，提高社区卫生服务能力；健全家庭医生考核激励机制；加强签约服务政策宣传。

关键词: 家庭医生, 签约服务, 影响因素分析, 对策