家庭医生签约服务是深化医药卫生体制改革的重要内容，自实施以来成效明显，但仍存在一些问题。运用ROCCIPI 分析框架，从7 个维度对家庭医生签约服务发展过程中的问题进行识别分析，发现家庭医生制度发展的各方面机会充足，但仍面临着较大的挑战：顶层设计不足，相关配套政策有待完善，未能有效协调各方利益，供需双方对制度的认识不到位，参与主动性不高，其服务能力、服务利用率、续约率和满意度均有待提高。建议通过完善政策环境，协调各方利益；加强组织管理，提高服务能力；加强宣传引导，明确政策认识这3 个方面推动家庭医生签约服务高质量发展。

Family doctor contracting service (FDCS) is an important part of deepening the reform of the medical and health system in China and has made significant achievements since its adoption. However, there are still some problems. Using the ROCCCIPI analysis framework, we identifi ed and analyzed the problems in FDCS from seven dimensions. It was found that there were both opportunities and challenges in development of FDCS: the top-level design is insuffi cient, the supporting policies need to be optimized, the interests of all stakeholders have not been effectively coordinated, both the supply and demand sides are not aware of the relevant policies, which lead to low initiative for participation. Therefore, the service capacity, service utilization, contract renewal rate, and satisfaction degree need to be improved. In order to promote the high-quality development of FDCS, the following three aspects are suggested: coordinate the interests of all stakeholders by improving the policy environment; strengthen the organizational management and improve service capabilities; and strengthen education and awareness-raising on the relevant policies.