Abstract: Background The health of primary and secondary school students in China faces many challenges. Against the policy background of the state strengthening physical health management and promoting family doctor contract services, it is imperative to extend family doctor contract services to functional communities such as schools. Objective Research on the design of family doctor contract service package suitable for the characteristics of Beijing from the perspective of grass roots medical and health institutions and schools, and provide for promoting the work of family doctor contract service in functional communities such as schools. Methods Using convenient sampling method, 62 participants, including heads of family doctor teams from community healthcare services and school doctors from primary and secondary schools in seven districts of Beijing were selected for a questionnaire survey in August 2024. The survey included the basic information of the respondents, assessing the necessity of basic health service package and four types of personalized service packages (vision, nutrition, oral, and psychological), covering service necessity, implementation feasibility, and recommendation rates. Results The overall recommended proportions of the basic health service package and four types of personalized health service packages were 83.5% (518/620), 74.2% (414/558), 72.2% (358/496), 66.6% (372/558), and 70.0% (304/434), respectively. Among them, the recommended proportions of services such as establishing and updating health records and vaccination services, visual health education and intervention services, nutritional counseling and guidance services, establishing student oral records service items, and establishing student mental health records services were relatively high, at 93.5% (58/62), 93.5% (58/62), 91.9% (57/62), 83.8% (52/62), 83.8% (52/62), and 77.4% (48/62), respectively. The recommended proportions of services such as carrying out self-filling screening scales for psychological problem screening, discovering common eye diseases such as conjunctivitis, nutritional therapy services, root canal therapy services, appropriate technologies such as psychological relief were relatively low, at 75.8% (47/62), 56.5% (35/62), 53.2% (33/62), 53.2% (33/62), and 59.7% (37/62), respectively. Apart from the necessity and feasibility of the Basic Health Service Package, the evaluations of the family doctor contract services for primary and secondary school students showed statistically significant differences between primary healthcare institutions and school medical professionals (P<0.01). Conclusion Basic health services, as well as personalized health record management, health education and intervention, and nutrition consultation and guidance services are key contents of the family doctor contract service package for primary and secondary school students in Beijing. The diagnosis and treatment service items are also necessary, but the items should selected and included in the contract service package according to the actual diagnosis and treatment capacity of the grass-roots medical and health institutions.

Key words: Family doctor contract services, Primary and secondary school students, Service demand, Basic health services, Personalized services

摘要： 背景 我国中小学生健康面临诸多挑战，在国家强化体质健康管理、推进家庭医生签约服务的政策环境下，推进家庭医生签约服务向学校等功能社区延伸势在必行。目的 从基层医疗卫生机构和学校双重视角，设计符合北京市特色的中小学生家庭医生签约服务包，为推进学校等功能社区家庭医生签约服务工作提供参考。方法 于2024年8月，采用方便抽样方法在北京市7个区选取社区卫生服务机构家庭医生团队负责人和辖区中小学校医共62名进行问卷调查，调查内容包括受访者基本情况及其对基础型健康服务包和4类个性化健康服务包（视力、营养、口腔、心理）的必要性评价、可行性评价及推荐意见。结果 基础型健康服务包和4类个性化健康服务包的总体推荐比例分别为83.5%（518/620）、74.2%（414/558）、72.2%（358/496）、66.6%（372/558）、70.0%（304/434）。其中，建立在校学生电子健康档案、预防接种疫苗、健康教育与干预、营养咨询与指导、建立学生口腔健康档案、建立学生心理健康档案服务的推荐比例较高，分别为93.5%（58/62）、93.5%（58/62）、91.9%（57/62）、83.8%（52/62）、83.8%（52/62）、77.4%（48/62）；采用自填心理筛查量表进行心理问题筛查、结膜炎等常见眼疾病筛查、营养治疗、根管治疗、适宜技术服务的推荐比例较低，分别为75.8%（47/62）、56.5%（35/62）、53.2%（33/62）、53.2%（33/62）、59.7%（37/62）。除基础型健康服务包项目的必要性、可行性评价外，家庭医生团队负责人和中小学校医对中小学生家庭医生签约服务包项目的各项评价比较，差异有统计学意义（P<0.05）。结论 基础型健康服务及个性化健康档案管理、健康教育与干预、营养咨询与指导服务是北京市中小学生家庭医生签约服务包应重点关注内容，诊疗服务项目也是必要内容，但应根据社区卫生服务机构的实际诊疗能力酌情选择项目纳入签约服务包。

关键词: 家庭医生签约服务, 中小学生, 服务需求, 基础型健康服务, 个性化服务