With the continuous development of the concept and practice of "patient-centered" medical and health service, the traditional family doctor contract service model, which focuses on single-disease treatment and management, cannot effectively meet the service needs of patients with multiple chronic diseases.

To explore that preference of patients with hypertension and type 2 diabetes for family doctor contract service in Hainan Province, and to provide empirical evidence for optimizing the contract service plan of family doctor.

A multi-stage stratified random sampling method was used to conduct a questionnaire survey from July 2023 to February 2024. The service preference of family doctors with hypertension and type 2 diabetes comorbid patients in Hainan Province was measured by discrete choice experiment (DCE). The set preference attributes were institutional nature, implementation environment, doctor's title, service mode, medication guidance and out-of-pocket expenses, service content attribute. A mixed Logit model was constructed with Python 3.11.7 software for preference analysis.

A total of 581 questionnaires were sent out, and 558 were valid, with an effective recovery rate of 96.0%. Six attributes, including institutional nature, implementation environment, doctor's title, service mode, medication guidance and out-of-pocket expenses, had significant effects on patients' preference for family doctor contracted service (P<0.05). The service content attribute had no significant effect (P>0.05). Patients with HTN-T2DM prefer to choose government-run institutions, door-to-door service, priority referral, senior doctor title, 50 yuan/month and 2 weeks medication guidance.

The institutional nature being government-run is the most highly valued attribute for patients. Home visit services and priority referral are important attributes that influence the preference for family doctor contracted services. It is suggested that a personalized family doctor contract service plan based on the preferences of patients with chronic diseases and comorbidities be formulated with a patient-centered approach to promote the high-quality development of family doctor contract services.

随着"以患者为中心"医疗卫生服务理念和实践的不断发展，传统以单病治疗和管理为主的家庭医生签约服务模式不能有效应对慢性病共病患者的服务需求。

了解高血压与2型糖尿病共病（HTN-T2DM）患者的家庭医生签约服务偏好，为优化家庭医生签约服务提供实证依据。

采用多阶段分层随机抽样法，于2023年7月—2024年2月开展问卷调查，通过离散选择实验（DCE）设计测量海南省HTN-T2DM患者的家庭医生签约服务偏好，设置的偏好属性为机构性质、实施环境、医生职称、服务内容、服务方式、用药指导、自付费用。借助Python 3.11.7软件构建混合Logit模型进行偏好分析。

共发放问卷581份，回收有效问卷558份，问卷有效回收率为96.0%。患者偏好分析发现，机构性质、实施环境、医生职称、服务方式、用药指导及自付费用显著影响患者的家庭医生签约服务选择倾向（P<0.05），服务内容对患者偏好的影响无统计学意义（P>0.05）。HTN-T2DM患者更愿意选择机构性质为政府办、服务方式为上门服务、有优先转诊、医生职称为高级、自付费用为50元/月及用药指导为2周的家庭医生签约服务。

机构性质为政府办是患者最看重的属性，上门服务、有优先转诊是影响家庭医生签约服务偏好的重要属性。建议"以患者为中心"，制定慢性病共病患者偏好的个性化家庭医生签约服务方案，以促进家庭医生签约服务高质量发展。