The service capabilities and sustainable development of community doctors' first contact are undoubtedly the critical factors to promote the construction of grassroots clinics and tiered health care system.Based on the review of motivation-related concepts and its development, as well as the analysis of the current conditions of community first contact and characteristics of community doctors in China, this paper puts forward and defines the concept and connotation of service motivation for community doctors' first contact by logically summarizing the concept of force in physical sciences ,motivation in service science, Based on analyzing the extrinsic motivations to form community doctors' first contact such as attraction, support, constraint, and stress the intrinsic motivations produced by professional identity, self-efficacy and achievement,as well as the interactions and relationships between them, this paper contructs a formation mechanism of the service motivation for community doctors' first contact, which is visual and intuitive.This paper provides a logical path and basis for scientific governance and upgrade of the service motivation for community doctors's first contact to effectively promote community first contact system in China.

Objective To further improve the comprehensive evaluation program of patient satisfaction in view of the defective item screening and weight design short of considerations for patients'psychological expectation and rational judgment, based on the theory of bounded rationality. Methods A satisfaction measurement scale was compiled and used to survey 847 inpatients in July-August 2017. The internal consistency test, correlation and factor analysis were used to evaluate the reliability and validity of the scale. The combination weight PWi was calculated based on patients' importance of the five satisfaction dimensions and the scoring of certainty degree of their responses. The combination weight EWi was calculated based on the five-dimension importance and operability scoring of expert consultation. The indicator combination weight OWi was determined using the integrated factors scoring, TOPSIS, weight rank-sun ratio, gray correlation method, and synthetic index method were used in a general assessment of patient satisfaction of a hospital in question. Results The Cronbach α coefficient of the patient satisfaction rating scale was 0.939, and the half-reliability coefficient was 0.951. The cumulative contribution rate of the five common factors variance extracted from the factor analysis was 71. 4%. The rational weights of five dimensions of service environment, service efficiency, service attitude, service technology, and service costs were 0.220, 0.214, 0.217, 0.179, and 0.171 respectively, while the comprehensive weights of the five dimensions were 0.115, 0.233, 0.196, 0.264, and 0.192 respectively. The comprehensive evaluation results of the two correlation coefficients were greater than 0.95. Conclusions The patient satisfaction measurement scale developed based on the theory of bounded rationality can expand the index connotation and items of core elements such as service technology and cost. The design of index weights fits with the concern of medical service factors and the degree of rational judgment in the patient's medical treatment process. The evaluation results are basically consistent with the actual situation and can be used as a reference tool for the scientific rational evaluation of patient satisfaction.

A high-level performance management system is indispensable for supporting the high-quality development of public hospitals.Under the background of comprehensive overhaul in the remuneration mechanisms within public hospitals and promotion of the contemporary management system of public hospitals,an increasing number of these hospitals are embracing per-formance-driven reform.Through a systematic analysis of the current issues in the remuneration system reform of public hospitals,this paper conducts a series of reform measures implemented within these public hospital to underscore the beneficial impact of ef-fective performance appraisal andremuneration incentives on the morale of medical staff and the sustainable cultivation of talent.This paper seeks to offer insights into enhancing remuneration system reforms and fostering high-quality development in public hospitals in the contemporary era.

Objective To explore the interaction between multiple governance subjects of the medical service system and their governance roles,and to provide theoretical support for the effectively enhancing of patients'sense of access to medical care.Methods Outpatients of different types of public hospitals in Hangzhou were selected as the research objects,question-naire surveys were conducted using quota sampling method,and hypotheses and models were verified using structural equation modelling technology.Results Statistical tests and path correction showed that the model had a good fit,and that the manage-ment of government departments,internal management of hospitals,service of medical staff,and cognitive attitudes had a positive impact on the sense of access to healthcare,with total effects of 0.71,0.63,0.38,and 0.12,respectively.Conclusion The construction of a collaborative governance model that takes government departments as the leader,public hospitals as the carrier,medical staff as the center axis,and patients as the centre is the best way to practice a collaborative governance model of various subjects,and is an excellent way to practice a collaborative governance model of various subjects.The synergistic governance model of various subjects is one of the critical strategies to practise people's co-construction and sharing and to enhance the sense of access to healthcare effectively.