Abstract: Background　To satisfy the healthcare needs of increased aging population and chronic disease population to improve the national health，it is essential to take actions to make full use of contracted family doctor services，and to improve the use of amount and quality of primary medication services，especially rational use of primary care in rural elderly chronic residents. Objective　To investigate the utilization of and satisfaction with medication services provided by the contracted family doctor in rural elderly chronic disease patients from Jiangsu Province. Methods　In July 2019，1 816 elderly patients with chronic diseases were selected by typical sampling and multi-stage stratified sampling in Jiangsu Province. The self-made questionnaire was used to investigate the utilization and satisfaction of elderly patients with chronic diseases in rural areas. Binary Logistic regression analysis was used to identify the associated factors of the satisfaction with medication services. Results　1 583 cases who effectively completed the questionnaire were finally enrolled. The prevalence of purchasing drugs from the village clinic or community health station，and from the township or community health center was 73.72%（1 167/1 583） and 11.62%（184/1 583），respectively. 1 449（91.53%） used the medication regimen developed by medical workers working at a village clinic or community health station and township health center or community health service center. 1 546（97.66%） took medicine according to the doctor's orders. 621（39.23%） had self purchase behavior. 1 402（88.57%） were satisfied with medication services provided by the family doctor. The satisfaction with medication services differed by household income，number of chronic diseases，place for drug purchase，source of medication regimen，and purchasing drugs by oneself（P<0.05）. Purchasing place was associated with the difference in the cost of drugs（P<0.05）. Purchasing place was associated with the difference in the cost of self-purchased drugs（P<0.05）. Binary Logistic regression showed that the degree of understandability of family doctor's explanation，condition control by the family doctor and the acceptability of cost of drugs prescribed by the family doctor were associated with the satisfaction with medication services（P<0.05）. Conclusion　The utilization of and satisfaction with the medication services provided by the contracted family doctor among rural elderly chronic patients were generally good. However，one-fourth of them purchased medications by themselves，which may suggest that medication services by the contracted family doctor could not fully meet their medication needs. Furthermore，their satisfaction with drug costs needs to be improved，which may be influenced mainly by the quality of medication services. To improve these contracted patients' use and satisfaction regarding primary medication services，we put forward the following recommendations：continuing to publicize favorable policies of medication services by the contracted family doctor，reducing the drug price to relieve contracted patients' disease burden，vigorously improving the professional level of family doctors，enriching the quantity and categories of available drugs，taking actions to provide medication convenience，and increasing long-term prescription services for chronic diseases.

Key words: Contracted family doctor services, Rural, Aged, Medication service, Chronic disease

摘要： 背景　随着老龄化进程加快且慢性病患者数量不断增加，如何进一步发挥家庭医生签约服务的作用，提高基层用药服务数量和质量，促进农村地区老年慢性病患者合理利用基层卫生资源并提升居民健康水平就显得尤为重要。目的　了解江苏省农村地区老年慢性病患者对于家庭医生用药服务的利用情况和满意度。方法　于2019年7月在江苏省通过典型抽样和多阶段分层抽样选取1 816例老年慢性病签约患者进行调查，采用自制患者问卷调查农村地区老年慢性病患者对家庭医生用药服务利用情况和满意度。采用二分类Logistic回归分析影响农村地区老年慢性病患者对家庭医生用药服务满意度的因素。结果　经数据清理，1 583份有效问卷纳入数据分析。1 167例（73.72%）在村卫生室/社区卫生服务站购买药品，184例（11.62%）在乡镇卫生院/社区卫生服务中心购买药品；1 449例（91.53%）签约患者的用药方案来自村卫生室/社区卫生服务站、乡镇卫生院/社区卫生服务中心的医务人员；1 546例（97.66%）按医嘱服药；621例（39.23%）有自购药品行为。1 402例（88.57%）对家庭医生提供的用药服务感到满意，不同家庭总收入、合并慢性病数、购药地点、用药方案来源、自购药品行为的患者用药服务满意度比较，差异有统计学意义（P<0.05）。不同购药地点患者的药费、自购药品费比较，差异有统计学意义（P<0.05）。二分类Logistic回归分析结果显示：家庭医生讲解易理解程度、家庭医生控制病情发展情况和家庭医生处药费易接受程度是农村老年慢性病患者用药服务满意度的影响因素（P<0.05）。结论　江苏省农村地区家庭医生用药服务利用总体情况良好。仍有 1/4 签约患者有自我购药行为，农村地区家庭医生用药服务不能完全满足老年慢性病患者用药需求，签约患者对药品费用满意度仍有待提高。家庭医生用药服务质量是影响签约患者满意度的主要因素。建议继续宣传家庭医生用药服务优惠政策，降低药品价格，减轻签约患者疾病负担，并着力提高家庭医生专业能力，丰富可提供药品数量和种类，增加慢病长处方用药服务，切实为农村老年慢性病患者用药提供便利。

关键词: 家庭医生签约服务, 农村, 老年人, 用药服务, 慢性病