With the continuous progress of the New Medical Reform, contracting service by family physicians has increasingly become an important guarantee for the basic medical care and health of the people, and the agreements of family doctors' contracting service has become the premise of achieving "everyone has a family doctor". However, the standardization and binding force of the agreement still remain to be studied.

By analyzing the agreements of family doctors' contracting services, we expected to further standardize the contracting services and improve the standardized management level of the services contracted by family doctors.

According to the purpose of the survey, the contracting agreements of the 14 community health service centers were finally selected as subjects by random sampling among 1-3 community health service centers in each of the nine main districts of Chongqing in July 2021. The main analysis framework was based on the contracting subject, contracted service, contracting fee mechanism, and the rights and obligations of the contracting subject. Finally, descriptive analysis of the agreements was performed by means of content analysis.

When compared the agreements in different districts, the contents of basic medical services and basic public health services were relatively similar (basic medical services included diagnosis and treatment services for common diseases, frequently occurring diseases and traditional Chinese medicine, etc., and basic public health services included establishing resident health files, providing health consultation, and vaccination, etc.) . There were differences in the terms of years of service, personalized services, etc. among family doctors in different regions of Chongqing: there were 12 agreements that specified a binding period of 1 year, 1 agreement whose duration was decided by the parties, and 1 agreement that did not specify the binding period. Among all agreements, the definition of the rights and obligations of contracting subjects and parties was vague. Among them, contracting subjects of 6 agreements included community health service centers, superior guidance hospitals, family doctors and representatives of heads of households or family representatives, 6 agreements included community health service centers, family doctors and representatives of heads of households or family representatives, 1 agreement included community health service centers and household heads, and 1 agreement did not specify the contracting subject.

It is necessary to further clarify the objects and agreements of contracting service, and improve the rights and obligations of the contracting subjects in Chongqing. Combined the experience of implementation of contracting services by family doctors of various regions, it is necessary to improve the performance effectiveness and the quality of the contracted services, and promote the implementation and development of the family doctors' contracting services.

随着新医改的不断推进，家庭医生签约服务越来越成为居民基本医疗卫生与健康的重要保障，而签约服务协议是实现"人人享有家庭医生"的前提，但协议内容的规范性和约束力尚待考量。

分析家庭医生签约服务协议内容，期望进一步提升家庭医生签约服务规范化管理水平。

结合调查目的，采用简单随机抽样法，于2021年7月在重庆市主城九区中的每个区随机抽取1~3家社区卫生服务中心，最终选取14家社区卫生服务中心的签约协议作为研究对象。以签约主体、签约服务、签约收费机制、签约主体的权利义务为主要分析框架，通过内容分析的方式，对协议进行描述性分析。

重庆市不同区域的家庭医生签约服务协议中基本医疗服务和基本公共卫生服务的内容较为相似：基本医疗服务内容包括提供常见病、多发病、中医药等诊疗服务，基本公共卫生服务内容包括建立居民健康档案、提供健康咨询、预防接种等。重庆市不同区域的家庭医生签约服务协议中对于服务年限、个性化服务等的规定存在差异：有12份协议规定签约期限为1年，1份协议的签约期限由签约双方协商决定，1份协议未标明签约年限。协议中对于签约主体、签约双方的权利义务的界定范围模糊：6份协议的签约双方为社区卫生服务中心、上级指导医院、家庭医生与户主或家庭成员代表，6份协议的签约双方为社区卫生服务中心、家庭医生与户主或家庭成员代表，1份协议的签约双方为社区卫生服务中心与家庭户主，1份协议未明确签约主体。

重庆市家庭医生签约服务协议应当进一步明确签约服务对象，完善签约主体的权利和义务，结合各地家庭医生签约服务开展经验，提升履约实效，使签约服务"提质增效"，促进家庭医生签约服务落到实处、向好发展。