目的:探讨扩大医院自主权对卫生人力培训发展的影响,从中吸取经验和教训。方法:采取定量与定性调查相结合,定量资料来源于县、乡两级医疗保健机构1987—2000年工作记录与报表;定性调查采取了召开专题小组讨论会、知情者访谈两种方式。结果:放权后领导观念变化,医务人员进修培训的积极性提高,培训数量增加;卫生人力结构优化,且知识和技术水平相应提高。结论:卫生服务管理权下放有利于卫生人力的培训与发展;但在贫困地区的乡镇卫生院由于资金紧缺,在扩大自主权的同时,政府还应辅以必要的前期入员培训经费。对培训造成的人才流失等负面影响,应通过制定政策,对预期亏损建立补偿机制,由受益单位与个人共同分担。 Objective: To explore the impact of expanding hospital autonomy on the development of health manpower training, and to draw lessons and lessons from it. Methods: Quantitative and qualitative surveys were used to combine quantitative data from the 1987-2000 work records and reports of county and township medical and health care institutions. Qualitative surveys were conducted in two ways: thematic panel discussions and interviews with insiders. Results: After the decentralization, the concept of leadership changes, the enthusiasm of the medical personnel for further training increases, and the number of training increases; the structure of the health workforce is optimized, and the level of knowledge and technology is correspondingly improved. Conclusion: The decentralization of health service management rights is conducive to the training and development of health workforce; but in township health centers in poverty-stricken areas, due to lack of funding, the government should also be supplemented with the necessary funds for early-stage recruitment training while expanding autonomy. Negative impacts such as brain drain caused by training should be determined through the formulation of policies and a compensation mechanism should be established for expected losses, which should be shared by the beneficiary units and individuals.