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目的:分析案例县在进行村卫生室建设中遇到各方参与积极性不足的问题及建成后卫生室使用率偏低的困境的原因并提出对策。方法:田野调查法、历史文献法和比较分析法。结果:项目投资体制存在严重弊端是导致村卫生室项目进展遇到问题的根本原因;村级医疗卫生事业的普遍性困境是导致村卫生室建成后难以得到高效利用的深层原因,当前我国村级医疗卫生事业面临的危机是一种总体性危机。结论:必须改革现行的项目投资体制;相应的制度设计和政策安排务必要结合农村的实际情况,考虑区域的发展差异,结合城乡二元结构的基本现实,以农民的实际需要为导向,绝不能搞城乡一刀切,更不能拍脑袋决策。
OBJECTIVE: To analyze the causes of the lack of enthusiasm for participation of all parties involved in the construction of village clinics and the dilemma of low utilization of clinics after the completion of the construction of village clinics, and to put forward countermeasures. Methods: field investigation, historical literature and comparative analysis. Results: The serious drawbacks of the investment system of the project are the root causes of the problems encountered in the progress of village clinics. The prevalence of village-level medical and health undertakings is the underlying reason that village clinics can not be efficiently utilized after the completion of the project. At present, The crisis facing the medical and health undertaking is a general crisis. Conclusions: The current project investment system must be reformed. The corresponding system design and policy arrangement must combine the actual conditions of the rural areas, consider the regional development differences, and combine the basic reality of the urban-rural dual structure with the peasants’ actual needs as the guideline. Do urban and rural areas across the board, but also can not make head decisions.