Abstract: Background　Primary healthcare workers are the main providers of contracted family doctor services（CFDSs）．Their responses to the supportive policies for the implementation of CFDSs and job satisfaction are the key to steadily promote the development of such services.Objective　To investigate primary healthcare workers' responses to the supportive policies for the implementation of CFDSs and job satisfaction，to provide recommendations for the sustainable development of such services.Methods　A questionnaire survey was conducted in a multistage stratified sample of 500 primary healthcare workers from Yichang City，Hubei Province during February to May 2018.The main contents of the survey included general personal characteristics，evaluation of CFDSs，responses to the supportive policies for the implementation of CFDSs，and job satisfaction.Stepwise multivariate Logistic regression analysis was used to analyze the influencing factors of job satisfaction.Results　Overall，462 participants handed in responsive questionnaires，obtaining a response rate of 92.4%.Among them，30.5%（141/462） played a role in delivering CFDSs very/comparatively actively，25.9%（120/462） reported that current incentive mechanism can motivate their working enthusiasm.The mean overall job satisfaction score，salary satisfaction score，working conditions satisfaction score，coworker relationships satisfaction score，personal development satisfaction score，and personal achievement satisfaction score obtained by the respondents were （17.4±3.5），（2.7±0.7），（3.4±0.7），（4.1±0.8），（3.3±0.9），（3.5±0.8），from "very unsatisfied" to "very satisfied"  were scored 1-5，respectively.Stepwise multivariate Logistic regression analysis revealed that mean monthly income，changes in working hours after delivering CFDSs，risks of being a family doctor，importance of family doctors，and the functions of current incentive mechanism in arousing the working enthusiasm were influencing factors for job satisfaction（P<0.05）．Conclusion　The levels of responses to the supportive policies for the implementation of CFDSs and job satisfaction in primary healthcare workers need to be improved.The suggested corresponding facilitation strategies are as follows：innovating the incentives for family doctors，improving the evaluation system of family doctors' performance in delivering CFDSs，strengthening the training of high-quality family medicine workforce，establishing a sustainable training system for family medicine workforce，and enhancing the stability of family doctor as a vocation.

Key words: Contracted family doctor services, Community health workers, Policy response, Job satisfaction, Optimization strategy

摘要： 背景　基层医务人员是开展家庭医生签约服务的主要执行者，其政策响应度和工作满意度是稳步推进家庭医生签约服务的关键。目的　探讨基层医务人员的家庭医生签约服务政策响应度及工作满意度，为促进签约服务的持续发展提供对策建议。方法　于2018年2—5月，采用多阶段抽样法在湖北省宜昌市抽取基层医务人员500例进行问卷调查，主要内容包括基本情况、对开展家庭医生签约服务的评价、对家庭医生签约服务的政策响应度及工作满意度。采用多因素Logistic逐步回归分析基层医务人员工作满意度的影响因素。结果　共回收有效问卷462份，问卷有效回收率为92.4%。30.5%（141/462）的医务人员非常/比较积极参与家庭医生签约服务，25.9%（120/462）的医务人员认为现有激励机制完全/比较能调动医务人员积极性。医务人员对工资薪酬、工作环境、同事关系、发展前景、个人成就感的满意度得分分别为（2.7±0.7）、（3.4±0.7）、（4.1±0.8）、（3.3±0.9）、（3.5±0.8）分（“很不满意”~“非常满意”分别计为1~5分），总体工作满意度得分为（17.4±3.5）分。多因素Logistic逐步回归分析结果显示，平均月收入、开展家庭医生签约服务后工作时间的变化、家庭医生岗位的工作风险、家庭医生岗位的重要性、现有激励机制能否调动医务人员积极性是基层医务人员工作满意度的影响因素（P<0.05）。结论　基层医务人员的家庭医生签约服务政策响应度与工作满意度均有待提高。建议创新基层医务人员的激励措施，完善签约服务工作价值的绩效考核；加强培养优秀的家庭医生队伍，建立长期家庭医生人才培养机制，提高家庭医生职业稳定性。

关键词: 家庭医生签约服务, 社区卫生工作者, 政策响应度, 职业满意, 优化策略