家庭医生签约服务中医患信任困境及优化路径

在家庭医生签约服务推行过程中，居民对家庭医生的信任度是影响家庭医生签约服务长效落实的关键因素之一。基于医患信任视角，聚焦制度信任、人际信任、群际信任等层面探讨家庭医生签约服务中面临的医患信任困境。提出了完善签约激励和监管机制，稳固制度信任；提高履约能力，促进人际信任；转变传统就医观念，增进群际信任等优化路径。揭示了医患信任在提升家庭医生签约服务质量，提高居民对基层医疗卫生服务利用率，推动分级诊疗可持续发展等方面发挥的重要作用。

Dilemma and Optimization Path of Doctor-patient Trust in Family Doctor Contracted Service

In the process of implementing family doctor contracted service, residents' trust in family doctors is a key factor affecting the sustained effectiveness of these services. Based on the perspective of doctor-patient trust, the paper focuses on the aspects of institutional trust, interpersonal trust and intergroup trust to explore the doctor-patient trust dilemma faced by family doctors. Based on this, the paper proposes optimization paths to address these dilemmas, such as improving incentive and supervision mechanisms to solidify institutional trust, enhancing performance capabilities to promote interpersonal trust, and transforming traditional healthcare perceptions to foster intergroup trust. It is revealed that doctor-patient trust plays an important role in improving the quality of contracted services of family doctors, improving the utilization rate of primary healthcare services, and promoting the sustainable development of hierarchical diagnosis and treatment.