Objective:To investigate residents' willingness of first diagnosis in community health service institutions(CHSI) and the influencing factors in Xuzhou, and improve the first rate.Methods:Residents were surveyed by a structured questionnaire. Descriptive Statistics, single factor analysis, and Logistic regression were applied to analyze data.95.0% of the questionnaires were effective. Results:79.0% residents were willing to accept the first treatment in the CHSI when they suffered from common diseases because of short distance, reasonable price; 94.7% residents were willing to accept the first treatment in hospitals when they suffered from serious diseases because of high quality, designated hospitals of medical insurances and large medical equipments. Binary Logistic analysis showed that residents preferred to first treatment in CHSI, who had lower average monthly income, lower medical costs, closer distance to primary medical institutions, far distance to general hospitals, experience of medical treatments in CHSI, and approving the hierarchical diagnosis and treatment system, the necessity of dual referral. Conclusion:Residents' willingness of first treatment in CHSI has been improved gradually, and the awareness that illness into hospitals improve constantly.