Family doctor contract services has become the main mode of primary medical and health service, but there is still no perfect, authoritative and feasible evaluation index system for family doctor contract services in our country.

The development of high-quality evaluation indicators for family doctor contract services aims to promote the high-quality development of family doctor contract services and improve the efficiency and quality of primary healthcare services.

From June to September 2023, through literature analysis, thematic group discussion, questionnaire survey and on-site interview, combined with the actual situation of family doctor service in Shanghai, the preliminary draft of the evaluation indicator system was formed. From October to November 2023, purpose sampling method was used to select 25 experts in general practice, public health, clinical medicine, health management and other fields in Shanghai, and these experts were interviewed by electronic questionnaire for two rounds. The evaluation index system of high-quality development of family doctor contract services was finally determined by Delphi method, and the weight of each index was determined by analytic hierarchy process. In the process, the basic information of experts, the enthusiasm of experts, the modification suggestions of experts, the degree of authority of experts, the degree of concentration of expert opinions, and the degree of coordination of expert opinions were recorded.

The effective response rates for the two rounds of expert consultations in this study were 100% and 96%, respectively. The familiarity coefficient (Cs) and judgment basis coefficient (Ca) for the first round of expert consultation were 0.864 and 0.920, respectively, and for the second round were 0.872 and 0.921, respectively. The authority coefficient (Cr) for both rounds were with values of 0.892 and 0.897 respectively. The Kendall coefficient (Kendall's W) for the two rounds were 0.201 (χ²=528.569, P<0.001)and 0.236 (χ²=607.250, P<0.001), respectively. Finally, an evaluation index system for the high-quality development of family doctor contract services was determined, which included 3 primary indicators of "service capacity, service quality, satisfaction and awareness", 8 secondary indicators, and 43 tertiary indicators. The weight coefficients of primary indicators were 0.334, 0.336 and 0.330, respectively.

This study showed a high level of expert enthusiasm, authority and coordination. After two rounds of consultation, the opinions of experts gradually converged, and the results of the evaluation index system for high-quality development of family doctor contract services were reliable, providing a scientific and objective evaluation tool for all regions in China to evaluate the effect of the family doctor contract service model.

家庭医生签约服务已经成为基层医疗卫生服务的主要模式，然而目前我国对家庭医生签约服务仍未形成一套完善的、权威的、可行性高的评价指标体系。

建立一套合理、可行性强的家庭医生签约服务高质量发展评价指标，从而推动家庭医生签约服务的高质量发展，提高基层医疗卫生服务的效率和质量。

于2023年6—9月，通过文献分析法、专题小组讨论、问卷调查和现场访谈，结合上海市家庭医生服务工作的实际情况，形成评价指标体系初稿。于2023年10—11月，采用目的抽样法选取上海市全科医学、公共卫生、临床医学、卫生管理等领域专家25名，使用电子问卷开展两轮问询，运用德尔菲法最终确定家庭医生签约服务高质量发展评价指标体系，并采用层次分析法确定各项指标权重，过程中记录专家基本资料、专家积极性、专家修改建议、专家权威程度、专家意见集中程度、专家意见协调程度。

本研究的两轮专家咨询有效问卷回收率分别为100%和96%；第1轮专家咨询的熟悉程度（Cs）和判断依据（Ca）分别为0.864和0.920，第2轮分别为0.872和0.921；两轮权威系数（Cr）分别为0.892和0.897；两轮肯德尔系数（Kendall's W）分别为0.201（χ²=528.569，P<0.001）和0.236（χ²=607.250，P<0.001）。最终确定了一个包含服务能力、服务质量、满意度及知晓度3项一级指标、8项二级指标、43项三级指标的家庭医生签约服务高质量发展评价指标体系，其中一级指标权重系数分别为0.334、0.336、0.330。

本研究在专家积极性、权威性和协调程度方面表现出较高水平，经过两轮问询专家意见逐渐趋于一致，最终构建出的家庭医生签约服务高质量发展评价指标体系结果可靠，为国内各地区提供了科学且客观的家庭医生签约服务模式开展效果评估工具。