Abstract: Background　The service quality of rural family doctors in China has aroused increasing attention. Scientific evaluation is a prerequisite for further targeted improvement of service quality. However，the current evaluation system of service quality of family doctors in China is regionally fragmented，and there is a lack of authoritative，reliable and guided evaluation tools. Objective　To develop a scale for service quality evaluation of rural family doctors，to apply to appropriately assess the service quality of family doctors in China. Methods　Under the guidance of the essence and profile of rural family doctor services in China in combination with useful information drawn from related global evaluation systems，on-site interviews and expert consultations，the primary scale was formulated. In June 2019，a pre-test was done using the primary scale and then the formal scale was formed after some modifications were done to the primary scale according to the results of analysis of pre-test items（n=308）. In July 2019，the modified scale was used for formal investigation，and the valid sample（n=1 746） was randomly divided into two parts. Sample 1（n=843） was used for item analysis，exploratory factor analysis and internal consistency test，and sample 2（n=903） was used for dimension correlation analysis and confirmatory factor analysis. Results　The formal scale includes 24 items in 6 dimensions：accessibility，horizontal continuity，vertical continuity，comprehensiveness，technology and affordability. The Cronbach's α of the scale was 0.910，and that for each dimension ranged from 0.755 to 0.912. The Bartlett's sphericity test result was significant（approximateχ2=12 492.540，P<0.05），and KMO test value was 0.880. The total variance explained by factors revealed by exploratory factor analysis was 70.347%. The interdimensional correlation coefficients were lower than dimension-total correlation coefficients. Results of confirmatory factor analysis were as follows：χ2/df=7.877，RMR=0.041，RMSEA=0.087，CFI=0.870，GFI=0.840，NFI=0.854. Conclusion　The scale developed in this study has good reliability and validity，which can be used as an effective tool to evaluate the service quality of rural family doctors in China.

Key words: Contracted family doctor services, Service quality, Scaling, Reliability, Validity, Rural

摘要： 背景　我国农村家庭医生签约服务质量问题日益受到关注，科学的服务质量评价是进一步针对性提升服务质量的前提，而当前国内家庭医生签约服务质量评价指标体系呈现区域碎片化问题，尚缺乏权威、可靠、具有指导性的评价工具。目的　编制家庭医生签约服务质量评价量表，为评估我国家庭医生签约服务质量提供适用的工具。方法　在我国家庭医生签约服务内涵与内容的指导下，参考国内外相关质量评价指标体系，结合现场访谈和专家咨询，设计初始农村家庭医生签约服务质量评价量表。于2019年6月，以初始量表进行预测试，根据样本（n=308）的项目分析结果，修订形成最终量表。于2019年7月，将最终量表用于正式调查，有效样本（n=1 746）被随机分为两部分，样本1（n=843）用于项目分析、探索性因子分析和内部一致性信度检验，样本2（n=903）用于维度相关分析和验证性因子分析。结果　最终量表包括6个维度（可及性、横向连续性、纵向连续性、综合性服务、技术性、经济性）24个条目。总量表的Cronbach's α系数为0.910，各维度的Cronbach's α系数为0.755~0.912。Bartlett's球形检验结果显著（近似χ2=12 492.540，P<0.05），KMO检验值为0.880，探索性因子分析的累积方差贡献率为70.347%。维度间相关系数低于各维度与总分之间的相关系数。验证性因子分析结果为：χ2/df=7.877，残差均方根（RMR）=0.041，近似误差均方根（RMSEA）=0.087，比较拟合指数（CFI）=0.870，拟合优度指数（GFI）=0.840，规范拟合指数（NFI）=0.854。结论　本研究编制的农村家庭医生签约服务质量评价量表具有较好的信度和效度，可作为我国农村家庭医生签约服务质量评价的有效工具。

关键词: 家庭医生签约服务, 签约服务质量, 量表编制, 信度, 效度, 农村