Primary care serves as the foundation of a well-functioning healthcare system and is critical for ensuring equitable access, early disease management, and cost-effective service delivery. In China, reforming primary-level healthcare institutions has become a national priority to achieve universal health coverage. Understanding the service users’ perspectives is essential to align primary care services with population health needs and improving trust in grassroots healthcare providers.

To evaluate satisfaction and unmet service needs among primary care users in Jiangsu Province, China.

A cross-sectional survey using structured questionnaires was given to 424 residents in urban and rural Jiangsu Province to measure satisfaction with primary hospitals, doctors, service preferences, and perceived gaps. Data was analyzed using descriptive statistics and chi-square tests to identify regional differences.

The primary care utilisation rate among respondents was 73.3%. While 75.2% reported satisfaction with medical expenses at primary-level facilities, significant urban-rural and regional differences were observed in service awareness, health policy knowledge, and perceived quality of doctor-patient communication. Primary care doctors received the highest ratings for using “easy-to-understand language”(mean score 4.13 ± 0.821) but lower scores for “professional competence” and “treatment effectiveness” (both 3.91). Rural inhabitants expressed high demand for services like management of common diseases (65.8%) and routine health examinations (52.4%), but highlighted shortages in advanced diagnostic tools (e.g., CT scans, endoscopy). Most inhabitants (67.2%) felt that primary care providers require improvement, particularly in clinical competency and communication.

The findings highlight areas for targeted policy interventions to improve primary care service delivery and capacity-building of primary care doctors in Jiangsu Province.