家庭医生签约服务自2016年全面推行，截至2025年，全国家庭医生总数达139.1万人 1。尽管规模不断扩大，该服务在实践中仍存在签约难、履约难、信任难等问题 1。为推动高质量发展，2025年7月，国家卫生健康委办公厅、国家发展改革委办公厅等印发《提升家庭医生签约服务感受度若干措施》 1。此外，今年7月印发的《国民健康“十五五”规划》提出推进家庭医生签约服务高质量发展；今年3月，国家医保局、国家发展改革委、国家卫生健康委印发《关于医保支持基层医疗卫生服务发展的指导意见》 1。
为提升履约质量和居民感受度，江苏南京、青海西宁、湖南湘潭等地通过团队化协作、信息化赋能、上下联动转诊、个性化服务包等举措展开实践 1。在湖南湘潭，当地推行“3+1+X”家庭医生团队模式，全人群家庭医生签约率为51.51%，慢性病患者、老年人等重点人群签约率为85.42% 1。湘潭搭建统一的基层医疗云平台，67家基层医疗机构全部接入，全流程数字化后，基本公共卫生服务的人力成本节约了40%以上 1。在激励机制上，个性化服务收入的70%可以返还给签约团队，岳塘街道社区卫生服务中心专门从事公共卫生和慢性病管理的医护人员，每人每月从签约服务中得到的收入为800至1000元 1。在上下联动转诊方面，湘潭市中心医院预留30%的号源和10%的床位供家庭医生顺畅对接 1。在江苏，全省已组建1.6万个家庭医生团队，开设专家工作室2447个、联合病房814个；南京三级医院向社区卫生服务中心开放14天以内的专家号，迈皋桥社区卫生服务中心2025年门诊量达27.8万人次，同比增长4.1% 1。
Family doctor contracted services have been fully implemented across the country since 2016, with the total number of family doctors reaching 1.391 million by 2025 1. The system still faces challenges such as difficulties in signing contracts, fulfilling service commitments, and establishing public trust 1. To address these issues, the General Offices of the National Health Commission and the National Development and Reform Commission, among other departments, issued the "Several Measures to Enhance the Experience of Family Doctor Contracted Services" in July 2025 1. The "15th Five-Year Plan for National Health" released in July 2025 proposed promoting the high-quality development of family doctor contracted services 1. In March 2025, the National Healthcare Security Administration, the National Development and Reform Commission, and the National Health Commission issued the "Guiding Opinions on Medical Insurance Support for the Development of Primary Healthcare Services" 1.
Surveys in Nanjing in Jiangsu, Xining in Qinghai, and Xiangtan in Hunan show that local areas are utilizing team collaboration, digital empowerment, linked referrals, and personalized service packages to improve service fulfillment and residents' satisfaction 1. In Xiangtan, the overall family doctor contracting rate is 51.51%, while the rate for key populations such as chronic disease patients and the elderly is 85.42% 1. The city has implemented a "3+1+X" family doctor team model and established a unified primary healthcare cloud platform connecting all 67 primary medical institutions 1. Following the full-process digitalization, the labor costs for basic public health services have been reduced by more than 40% 1. Furthermore, 70% of the income generated from personalized services can be returned to the contracted teams 1. At the Yuetang Street Community Health Service Center, healthcare professionals dedicated to public health and chronic disease management receive 800 to 1,000 yuan per month per person from these contracted services 1.
In Jiangsu Province, 16,000 family doctor teams have been formed, along with 2,447 expert studios and 814 joint wards 1. In Nanjing, tertiary hospitals reserve specialist appointments within 14 days for community health service centers 1. The Maigaoqiao Community Health Service Center recorded 278,000 outpatient visits in 2025, representing a 4.1% year-on-year increase 1. Xiangtan Central Hospital allocates 30% of its appointment slots and 10% of its beds for seamless referral coordination by family doctors 1.
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