Abstract: Objective　To discuss the current situation of family doctor contracted services and its satisfaction degree in Jiangsu Province to provide reference for the further development of family doctor contracted services.Methods　Multistage sampling method was conducted.Eight primary medical institutions（four community health centers and four township health centers） from each of 13 cities in Jiangsu Province were selected by typical sampling method，in which the family doctor contracted services was implemented.And three doctors from each of primary medical institutions were selected by random number table method to fill in the questionnaires.A total of 312 doctors conducted a self-designed questionnaire from November to December in 2016.The questionnaire mainly included general situation of family doctors，current situation of the contracted services，residents' cognition and enthusiasm of contracted services and their satisfaction level.A total of 312 questionnaires were distributed and 296 valid questionnaires were collected.The effective rate was 94.9%.Results　Among 296 doctors，the number of contracted residents of each doctor was from 0 to 8 380 with the median of 220（790）．Family doctors thought that the reasonable number of contracted residents of each doctor should be from 0 to 3 000 with the median of 200（420）．The working time of 150（50.7%） doctors was 9 to 10 hours.Working time engaged in the contracted services accounted for 3% to 99% of the total working hours with the median of 30%（30%）．And 175（59.1%） doctors saw no change in salary basically.While 254（85.8%） doctors were clear about the contents of contracted services，275（92.9%） doctors knew responsibilities of family doctors．Then 260（87.8%） doctors thought that they were qualified for the family doctor contracted services，while 171（57.8%） doctors were positive in the contracted services.The average score of satisfaction degree to the contracted services of urban family doctors was（3.37±0.05），and that of rural family doctors was（3.54±0.05）．Scores of rural family doctors on the support of agencies，referral services provided by the superior hospital，social environment and overall satisfaction degree were higher than that of the urban family doctors with a significant difference（P<0.05）．There was no significant difference in the satisfaction degree of family doctors with different sex，age and practicing registration（P>0.05），while there was a significant difference in the satisfaction degree of family doctors with different education level and professional titles（P<0.05）．Conclusion　There is a certain gap between the actual number of residents contracted with family doctors and the number guided by policy，which needs the improvement of relevant policies.Family doctors have limited time to engage in the contracted services，and therefore more doctors are needed.Family doctors have a good self-evaluation with positive enthusiasm，and their service capabilities need to be further improved.Family doctors are less satisfied with personal development，and incentive mechanism should be improved.

Key words: Family doctor, Contracted services, Present situation, Degree of satisfaction

摘要： 目的　探讨江苏省家庭医生签约服务工作现状及满意度，为进一步推进家庭医生签约服务提供参考依据。方法　采用多阶段抽样方法，首先在江苏省13个市每市采用典型抽样法抽取8个已实施家庭医生签约服务的基层医疗卫生机构（4个社区卫生服务中心、4个乡镇卫生院），再采用随机数字表法在每个机构中随机抽取3名开展签约服务的家庭医生为研究对象，共计312名。于2016年11—12月，采用自行设计的调查问卷进行调查。问卷主要内容有：家庭医生的基本情况、签约服务工作现状、对签约服务的认知和积极性以及对签约服务的满意度。共发放问卷312份，回收有效问卷296份，问卷的有效回收率为94.9%。结果　296例家庭医生中，每例家庭医生已签约人数为0~8 380例，中位数为220（790）例；家庭医生认为合适的签约人数为0~3 000例，中位数为200（420）例。每日工作时间为9~10 h者150例（50.7%）；从事签约服务时间占总工作时间的比例为3%~99%，中位数为30%（30%）；认为薪酬基本无变化者175例（59.1%）；对签约服务内容认知很/比较清楚者254例（85.8%）；对家庭医生职责很/比较明确者275例（92.9%）；认为完全/基本能够胜任签约服务工作者260例（87.8%）；很/比较积极参与签约服务工作者171例（57.8%）。城市家庭医生对签约服务的满意度评分平均为（3.37±0.05）分，乡村家庭医生对签约服务的满意度评分平均为（3.54±0.05）分；乡村家庭医生对签约服务中机构的重视与支持、上级医院提供的转诊服务、所在社会环境及总体满意度评分高于城市家庭医生，差异有统计学意义（P<0.05）。不同性别、年龄、执业注册类别的家庭医生对签约服务的总满意度评分比较，差异无统计学意义（P>0.05）。不同文化程度、职称的家庭医生对签约服务的总满意度评分比较，差异有统计学意义（P<0.05）。结论　家庭医生签约人数与政策指导建议存在一定的差异，需进一步推进政策实施；家庭医生投入签约服务时间有限，需加强人员配备；家庭医生自我评估良好，参与积极性较好，需继续提升服务能力；家庭医生对个人发展满意度较低，需完善激励机制。

关键词: 家庭医生, 签约服务, 现状, 满意度