The existing family doctor team performance appraisal system is lack of incentive effect, which has hindered the quality development of contracted family doctor services. However, the performance appraisal system based on family doctor teams includes two processes of "primary distribution" and "secondary distribution", which is more capable of mobilizing the work motivation of the family doctor team members. At present, there is a lack of performance evaluation indicator systems for family doctor assistants and public health physicians, although these two groups of people play an important role in the family doctor team.

To construct "secondary distribution" indicator system of family doctor team performance based on contracted service fee, with regard to the roles of family doctor assistants and public health physicians.

The draft of the "secondary distribution" indicator system of family doctor team performance was preliminarily formulated through literature analysis and semi-structured interview. On the basis of the draft, an expert consultation questionnaire was designed, and two rounds of expert consultation were implemented and completed from October 2021 to April 2022 to develop the "secondary distribution" indicator system of family doctor team performance based on contracted service fee was established.

The recovery rates of the two rounds of expert consultation questionnaires was 100.0%. For the secondary distribution system of family doctor assistants and public health physicians, the authority coefficient for the first round of correspondence was 0.742 2 and 0.742 0, respectively. Finally, the "secondary distribution" indicator system of family physician assistants, including 3 first-level and 10 second-level indicators, and the "secondary distribution" indicator system of public health physicians, including 3 first-level and 13 second-level indicators, were constructed.

The final "secondary distribution" indicator system of family physician assistants with 3 primary indicators and 10 secondary indicators and "secondary distribution" indicator system of public health physicians with 3 primary indicators and 13 secondary indicators is logical and scientific to a certain extent, reflecting the labor value of family doctor assistants and public health doctors in the family doctor team in providing contracted services, which is conducive to the special incentive function of contracted service fee and needs to be optimized and improved in the actual assessment in the future.

现有的家庭医生团队绩效考核体系缺乏足够的激励效果，阻碍了家庭医生签约服务的高质量发展，而以家庭医生团队为单位的绩效考核方案包括"一次分配"和"二次分配"两个过程，更能调动家庭医生团队成员的工作积极性。家庭医生助理和公共卫生医师两类人群在家庭医生团队中发挥着重要作用，但目前缺乏针对性的绩效考核指标体系。

针对家庭医生团队中的家庭医生助理和公共卫生医师两类角色，构建基于签约服务费的家庭医生团队绩效"二次分配"指标体系。

通过文献归纳分析与半结构访谈，初步拟定家庭医生团队绩效"二次分配"指标体系草案。在草案基础上设计专家咨询问卷，并在2021年10月—2022年4月实施并完成两轮专家咨询，构建了基于签约服务费的家庭医生团队绩效"二次分配"指标体系。

两轮专家咨询问卷的回收率均为100.0%。对于家庭医生助理的二次分配体系，第一轮函询的专家权威系数为0.742 2；对于公共卫生医师的二次分配体系，第一轮函询的专家权威系数为0.742 0。最终构建了包括一级指标3个、二级指标10个的家庭医生助理"二次分配"指标体系和包含一级指标3个、二级指标13个的公共卫生医师"二次分配"指标体系。

本研究最终构建了包括一级指标3个、二级指标10个的家庭医生助理"二次分配"指标体系和包含一级指标3个、二级指标13个的公共卫生医师"二次分配"指标体系，其具备一定逻辑性和科学性，体现了家庭医生团队中家庭医生助理和公共卫生医师提供签约服务的劳务价值，有利于发挥签约服务费的专项激励作用，未来需运用于实际考核中进行优化与完善。