Objective  To examine the intention in medical institution selection for diagnosis and treatment of chronic diseases and its influencing factors among adult residents of urban Xuzhou, Jiangsu province and to provide references for rational allocation of medical resources and improvement of medical service.

  Methods  Using stratified random sampling, we conducted a face-to-face survey among 750 permanent adult residents (> 18 years) in 6 communities of urban Xuzhou with a self-designed questionnaire during July – August 2016.

  Results  Of the 710 residents completing the survey, 42.3% (300) reported the intention of selecting grass-roots medical institutions when suffering from a chronic disease; 24.2% (172) and 33.5% (238) reported the intention of selecting medical institutions at district and municipal level. The results of multivariate logistic regression analysis revealed that the participants with a monthly income of 3 000 yuan (RMB) and more in previous one year were more likely to select medical institutions at district or municipal level; whereas, the participants aged 50 and above, ever having medication in community healthcare service institutions (CHSI), and being aware of hierarchical diagnosis and treatment system and with a supportive attitude to the system were more likely to select CHSI.

  Conclusion  Among adult residents in urban communities of Xuzhou city, the intention of selecting grass-roots medical institutions for chronic disease medication services is at a low level and the intention of medical institution selection is influenced mainly by age, average monthly income in previous year, experience of having medical services in CHSI, and the awareness of the hierarchical diagnosis and treatment system and supportive attitude towards the system.