论文部分内容阅读
目的从农村卫生服务管理者、组织者和提供者入手,分析其对现行乡村医生队伍走向、服务模式改革的举措及其可行性等方面的意向。为上海市乡村医生服务模式实践改革提供科学的依据。方法采用分层整群随机抽样的原则,调查并分析上海市8个郊区(县)24个乡镇72个村312名农村卫生服务组织者和提供者的意向。结果和讨论如果乡镇卫生院对乡村医生队伍进行替代,乡镇卫生院需要继续提供24小时随叫随到的服务(70.1%的认可率),而乡镇卫生院不具有24小时电话预约、随叫随到的服务能力(63.3%的认可率)。乡村医生由乡镇卫生院医务人员替代是不可行的(75.7%的认可率)。相反,应通过增加政府重视和政策保障,实行乡村卫生服务一体化管理,实行乡村医生聘用制,择优录用,竞争上岗,完善评估和考核机制等,明确乡村医生性质和地位,增加乡村医生收入,加强乡村医生培训等,保留和稳定这一队伍以适应形势不断发展的需要(98.3%的认可率)。
Objective To start with the managers, organizers and providers of rural health services and analyze their intentions toward the trend of the current rural doctors team and the reform of service mode and their feasibility. Provide a scientific basis for the practice and reform of the service mode of rural doctors in Shanghai. Methods The stratified cluster random sampling method was used to investigate and analyze 312 rural health service organizers and providers in 72 villages in 24 towns and villages in 8 suburbs of Shanghai. Results and Discussion Township hospitals need to continue providing on-call 24 hours service (70.1% approval rate) if township clinics substitute for village doctors, while township hospitals do not have a 24-hour telephone reservation. To the service capacity (63.3% recognition rate). It is not feasible for rural doctors to be replaced by medical workers in township hospitals (75.7% acceptance rate). On the contrary, it is necessary to clarify the nature and status of village doctors by increasing the government’s attention and policy support, implementing the integrated management of rural health services, implementing the appointment system of rural doctors, employing merit candidates, competing for posts, improving assessment and assessment mechanisms, increasing the incomes of rural doctors, To strengthen the training of village doctors, etc., to retain and stabilize the team to meet the evolving needs of the situation (98.3% recognition rate).