Abstract: Background　Zhengzhou has initially developed a multi-area，deep-seated and wide-ranging urban community health service network based on the "physician accountability system in delivering healthcare for each area" proposed in 2008.However，some relevant studies show that problems such as unbalanced development among communities and irregular management still exist.With the constant advancement of the contracted family doctor services，the contracted residents' satisfaction with and use of the contracted services need further investigation and analysis.Objective　To explore contracted residents' utilization of and satisfaction with the contracted services as well as the associated factors in Zhengzhou，providing a theoretical basis for promoting the development of such services.Methods　This face-to-face survey was conducted from September to October 2018 in 1 000 contracted residents living in the serving areas of two community health centers（CHCs），Zhengzhou，selected by use of two-stage sampling.A self-made questionnaire developed based on the EUROPEP questionnaire（extended version） was used in the survey，which consisted of sociodemographic data，use of，and overall and specific satisfaction with 10 essential family doctor services，changes in community health services spending，health literacy，and number of CHCs visits.Results　The contracted residents' satisfaction levels with the 10 essential family doctor services were good or above good.Essential medical services〔（10.16±0.33）times〕，and public services〔（8.51±0.27）times〕 were used more often，while priority referral services〔（3.40±0.13）times〕 and long-term prescription services〔（2.57±0.08）times〕 were used less frequently.After contracting，most of the residents（57.9%） thought that no changes were found in their community health services spending，but the majority of residents（71.7%） reported that their health literacy increased，and 53.3% reported to have increased CHCs visits.Of the 30 items of the EUROPEP questionnaire，"Listen to your share about the illness（37.6%）" "Establishment and management of health records（36.6%）" "Providing related services for disease prevention（35.7%）" and other dimensions of doctor-patient communication，disease prevention and health care got the higher respond rate with the "very satisfied"，while "Get help from other employees（15.1%）" "Provide comprehensive diagnosis and treatment（12.2%）" and "waiting time for treatment（8.4%）" and other dimensions of technical support and service organization got lower respond rate with the "very satisfied". Education level was a influencing factor of satisfaction level with family doctor services（P<0.05），and having chronic diseases，and the visited CHC being a member of the regional medical consortium were associated with higher satisfaction level with family doctor services（P<0.05）.Conclusion　The implementation of contracted family doctors services in Zhengzhou focuses on the delivery of essential medical services，which can enhance residents' awareness of disease prevention and health care，and promote the effective communication between doctors and patients.However，the service organization is still inadequate.So adequate cooperations among medical institutions should be further strengthened to promote the development of contracted family doctor services.

Key words: General practitioners, Contracted family doctor services, Current situation, Patient satisfaction, Zhengzhou

摘要： 背景　郑州市于2008年提出的“片医负责制”初步构建了多区域、深层次、广覆盖的城市社区卫生服务网，但相关研究表明存在社区间发展不均衡、管理不规范等问题。随着家庭医生签约服务的不断推进，签约居民的满意度及对服务的利用情况还需进一步调查和分析。目的　探讨郑州市签约居民对家庭医生签约服务利用情况、满意度及影响因素，为推动家庭医生签约服务发展提供理论依据。方法　采用二阶段抽样法，于2018年9—10月选取郑州市2家社区卫生服务中心辖区内的家庭医生签约居民1 000例为研究对象，在扩展型欧洲满意度量表（EUROPEP量表）的基础上采用自制问卷对其进行面对面调查。问卷内容包括签约居民的基本情况，签约居民对10项基本家庭医生签约服务的利用情况及满意度，签约后居民在社区医疗支出、健康素养、去社区卫生服务中心就诊次数的变化情况，签约居民对家庭医生签约服务的满意度评价。结果　签约居民对10项基本服务的满意度处于一般以上水平，其中利用较多的服务为基本医疗服务〔（10.16±0.33）次〕、公共卫生服务〔（8.51±0.27）次〕，利用较少的服务为优先转诊服务〔（3.40±0.13）次〕、长期处方服务〔（2.57±0.08）次〕；多数签约居民认为签约后社区医疗支出没有变化（57.9%）、健康素养提升（71.7%）、在社区卫生服务中心就诊次数增加（53.3%）；EUROPEP量表30个条目中，“认真耐心地倾听您对病情的诉说（37.6%）”“健康档案的建立和管理（36.6%）”“给您提供预防疾病的相关服务（35.7%）”等有关医患沟通和预防保健维度的“非常满意”应答率较高，而“能够得到其他员工（如护士、药剂师）的帮助（15.1%）”“全面地给您提供诊断和治疗（12.2%）”“在候诊室里等待看病的时间（8.4%）”等有关服务组织、技术支撑维度的“非常满意”应答率较低。学历是签约居民对家庭医生签约服务满意度的影响因素（P<0.05），患慢性病、所在社区卫生服务中心加入区域医疗联合体的签约居民家庭医生签约服务满意度得分较高（P<0.05）。结论　郑州市家庭医生签约服务重在落实基本医疗，能够增强居民预防保健意识、促进医患有效交流，但服务组织还不够完善，应进一步加强各级医疗机构间的协调合作，做好家庭医生签约服务。

关键词: 全科医生, 家庭医生签约服务, 现状, 病人满意度, 郑州