论文部分内容阅读
目的通过调查福建省乡村医疗服务监督的特点,分析存在的问题,探讨原因,提出促进乡村医疗服务监督发展的政策建议。方法采用现场调查法、文献研究法和专家咨询法,抽取福建省的六个县区为样本,通过对卫生监督员和协管员的问卷调查和访谈,同时现场调查基层卫生监督机构和部分医疗机构,了解乡村医疗服务监督的运行情况以及存在的问题,对照法律、法规和规定以及相关理论和实践提出政策建议。结果乡镇卫生院医疗资源缺乏,普遍存在医师、医技人员少,造成医师超范围行医的问题。有些地方行政许可把关不严。村卫生所、诊所存在有过期药品等不规范执业问题。村卫生所、诊所普遍存在无核准开展静脉输注。村医的老龄化,空白村现象严重。乡村一体化中“村改居”后原村卫生所大多转型没有为社区卫生服务机构,而这些乡村医生的依然处于从业状态。结论乡村医疗服务资源相对贫乏,政府和社会必须做出一些扶持措施,以避免造成依法执业的某些困境。加强乡村医疗服务监管力量和监管水平,解决存在乡村医疗机构的超范围行医、使用过期药品等不规范行医的问题。重视“村改居”后乡村医生可能造成的非法行医问题,应从政策、管理和监督多方面着手花大力气解决。严格规范医疗许可行为,为医疗服务监督提供良好的基础。
Objective To investigate the characteristics of rural medical service supervision in Fujian Province, analyze the existing problems, discuss the reasons and put forward some policy recommendations to promote the supervision and development of rural medical services. Methods The methods of on-the-spot investigation, literature research and expert consultation were used to extract samples from six counties in Fujian Province. Through questionnaires and interviews with health supervisors and coordinators, on the spot investigation of grass-roots health supervision agencies and some medical services Agencies to understand the operation of rural medical services supervision and existing problems, and make policy recommendations in accordance with laws, regulations and rules as well as related theories and practices. Results The township hospitals lack of medical resources, widespread physicians, medical staff, resulting in physicians over the scope of practice. Administrative clearance in some places is not strict. Village clinics, clinics, there are outdated drugs and other non-standard practice issues. Village clinics, clinics prevailed without permission to carry out intravenous infusion. The aging of village doctors, blank village serious. In the village integration, most of the village clinics were not community health service institutions, and these rural doctors are still in the state of employment. Conclusion Rural medical service resources are relatively scarce, and the government and society must make some supportive measures to avoid certain difficulties that cause them to practice according to law. Strengthen the supervision and management of rural medical services, and solve the problem of non-standard medical practices such as the excessive use of medical services in rural areas and the expired drugs. Attention should be paid to the possible illegal medical practice that village doctors may cause after the “reform of the village and living in a changed home.” We should make great efforts to solve this issue in various aspects of policy, management and supervision. Strictly regulate the medical licensing behavior and provide a good foundation for medical service supervision.