Abstract: Background　The implementation of family doctor services is a major task for promoting the allocation of high-quality medical resources to primary care since the healthcare reform initiated in 2009 in China. Sichuan and Chongqing are located in the southwest of China. Family doctor service is related to the livelihood of the local people. In the new era of basic medical and health services and other services，it is of great significance to understand the situation of family doctor service supply side contract signing. Objective　To investigate the prevalence of signing a contract to attend a family doctor team and intention and associated factors of renewing the contract upon the termination date among medical workers in Sichuan and Chongqing，providing a reference for promoting supply-side structural reform of family doctor services，and improving relevant performance allocation and assessment systems as well as supervision and inspection system in these regions. Methods　By using the method of multi-stage sampling，1 550 medical workers from 60 medical institutions in Sichuan and Chongqing were selected and received a questionnaire survey from March to August 2019. The content of the questionnaire includes basic information, cognition, attitude and willingness of the contracted family doctor team. Binary Logistic regression was used to analyze the associated factors of renewing the contract upon the termination date among medical workers. Results　1 402（97.91%） valid questionnaires were collected and 752（53.64%）medical workers were willing to renew their contracts. The intention of renewing the contract upon the termination date among medical workers differed by the age，the level of hospitals and the annual income（P<0.05）. The intention of renewing the contract upon the termination date varied by medical workers' perceptions and attitudes regarding policies and scope items related to family doctor services，and the necessity of implementing the services，improvement degree of systems associated with family doctor service programs，prospect of family doctor service programs，and the duration of the contract（P<0.05）. Logistic regression analysis showed that age，the level of mastering policies related to family doctor services，understanding of the necessity of implementing the services，and attitudes toward the prospect of such services were associated with renewing the contract upon the termination date（P<0.05）. Conclusion　The willingness to renew the contract on the supply side of family doctor service in Sichuan and Chongqing is not very high. The medical staff who are older，have a clear understanding of the family doctor service policy，think it is necessary to implement the family doctor service project，and are more optimistic about the prospect of the family doctor service project are more willing to renew the contract.

Key words: Contracted family doctor services, Cognition, Attitude, Renewal intention, Root causes analysis, Sichuan-Chongqing area

摘要： 背景　家庭医生服务是我国新医改后促进优质医疗资源下沉的重要任务之一，川渝地区位于我国西南部地区，家庭医生服务关系当地群众健康保障的民生问题，在基本医疗卫生服务与其他服务齐头并进的新时代，了解家庭医生服务供给侧签约情况具有重要意义。目的　了解川渝地区家庭医生服务供给侧签约现况和续约意愿，分析影响家庭医生团队续约因素，为该地区推动供给侧结构性改革、深化绩效分配和考核制度、完善督查制度等提供一定参考。方法　于2019年3—8月，采用多阶段抽样方法，选取川渝地区60所医疗机构1 550例医务人员进行问卷调查。问卷内容包括基本情况，对签约家庭医生团队的认知、态度、意愿两部分。采用二分类Logistic回归分析家庭医生团队医务人员签约期结束后续约的影响因素。结果　本次调查回收有效问卷1 402份（97.91%），愿意续约者752例（53.64%）。不同年龄、医疗机构类别、年收入水平的医务人员签约期结束后续约意愿比较，差异有统计学意义（P<0.05）。对家庭医生服务政策、家庭医生的服务内容、推行家庭医生服务必要性、现行家庭医生服务项目制度完善程度、家庭医生服务项目未来前景的态度、签约家庭医生团队时长具有不同认知和态度的医务人员签约期结束后续约意愿比较，差异有统计学意义（P<0.05）。Logistic回归分析结果显示：医务人员的年龄、对家庭医生服务政策的把握、对家庭医生服务推行必要性认识、家庭医生服务项目前景的态度均是签约期结束后续约的影响因素（P<0.05）。结论　川渝地区家庭医生服务供给侧续约意愿总体不是很高。相比较而言，年龄较大、对家庭医生服务政策把握清晰、认为家庭医生服务项目推行有必要、更看好家庭医生服务项目前景的医务人员续约意愿较高。

关键词: 家庭医生签约服务, 认知, 态度, 续签意愿, 影响因素分析, 川渝地区