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介绍《乡村卫生组织一体化管理政策研究和实践》项目的研究背景、目的、内容和主要方法 ,以及该政策思路在样本地区实施后的社会效果与影响。评价结果表明 ,乡村卫生组织一体化管理 ,能够缓解乡镇卫生院生存困境 ,能避免乡村两级卫生机构的恶性竞争并恢复协调 ,促使乡镇卫生院加强村卫生室的管理和建设 ,提高了村医素质 ,统一和规范了村卫生室和村医的进药渠道 ,村乡两级防保人员的数量和素质改善。一体化的效果与管理观念紧密相连 ,如管理不当 ,一体化的经济收益维持不了多久 ,村卫生室原有的“产权明晰、责任明确”的体制优势 ,以及有积极性较高、就医较方便、服务价格较低、服务态度较好等特点将会逐步丧失 ,居民就医经济负担加重 ,医疗服务的可及性下降。以医养防现象加重 ,重医轻防依旧存在。并提出了将一体化管理与村乡乃至县卫生机构的劳动人事、分配制度和改革相结合的建议
The research background, purpose, content and main methods of the “Research and Practice on Integrated Management Policy of Rural Health Organizations” were introduced, as well as the social effects and impacts of the implementation of the policy ideas in the sample areas. The evaluation results show that the integrated management of rural health organizations can alleviate the predicament of township health centers, can avoid the vicious competition of village health institutions at both levels and restore coordination, and urge township hospitals to strengthen the management and construction of village clinics and improve village doctors. Quality, unified and standardized the village clinics and village doctors into the drug channels, the number of village and township security personnel and the quality of the improvement. The effect of integration is closely linked to the concept of management. If the management is not properly managed, the integrated economic benefits will not last long. The village clinic has the original institutional advantages of “clear property rights and clear responsibilities”, as well as high enthusiasm and convenient medical treatment. The characteristics of lower service prices and better service attitudes will gradually be lost, residents’ financial burden on medical care will increase, and the availability of medical services will decline. The phenomenon of increasing the health of the medical practitioners has been aggravated, and doctors still have lighter defenses. It also proposed the integration of integrated management with the labor personnel, distribution system, and reforms of the health institutions in villages and counties.