Objective: This study investigated Dongguan residents' cognition on policies related to first visit at the grassroots level, analyzed the influencing factors of Dongguan residents' willingness to have primary care at the grassroots level, and explored means to optimize residents' support for compulsory primary diagnosis. Methods: The questionnaire survey was conducted among 350 residents in Dongguan by simple random sampling. Descriptive analysis, chi-square test and decision tree model analysis were carried out with SPSS 26.0 software. Results: The majority of Dongguan residents support first visit at the grassroots level (83.8%) and graded diagnosis and treatment system (70.0%), and over half of them are satisfied with the referral process (62.7%) and disapprove of the compulsory first visit at the grassroots level (65.4%). Less than 30% of residents trust in primary medical institutions. In the decision tree analysis of the willingness to see a doctor at the grassroots level, the trust of infrastructure and the satisfaction of referral process are important predictors of the willingness to see a doctor at the grassroots medical institutions. Conclusion: It is necessary for the government to vigorously strengthen the publicity of policies and systems related to primary care at the grassroots level, continue to improve the service capacity of primary medical institutions, optimize the referral process and enrich the content of referral work.