中文摘要：

目的：探讨基本药物制度背景下乡村医生的社会地位与利益诉求。方法于2012年8—12月采用多阶段分层随机抽样法抽取山东省134个村卫生室的621名乡村医生为研究对象，收集基本药物制度实施前后乡村医生收入及同村乡村教师和村干部的工资水平。以收入为社会分层指标，分析基本药物制度前后乡村医生社会地位的绝对变化以及与参照群体相比的相对变化，利用开放性问题和定性访谈了解乡村医生的利益诉求。结果共发放问卷621份，全部收回，有效回收率为100.0％。基本药物制度实施后，乡村医生的平均年收入由实施前的22578.4元下降为实施后的13399.9元，下降了9178.5元；平均年收入比村干部（16857.4元）低3457.5元，比乡村教师（33932.7元）低20532.8元。年轻乡村医生期望年收入高于年老乡村医生〔≤30岁（42529.4±21435.8）元比31～45岁（37948.1±17371.5）元比≥46岁（34559.4±14720.2）元〕，差异有统计学意义（P＜0.05）。乡村医生的利益诉求主要集中在收入（86.8％，383/480）、养老保障（59.0％，260/480）、职业风险（32.2％，142/480）和工作负荷（27.4％，121/480）方面，87.2％（524/601）的乡村医生希望以“事业编制”形式取得保障，自我提升的需求不足。结论由于基本药物制度的实施，乡村医生收入减少，社会地位下降。其利益诉求以满足生存安全的低层次需求为主，高层次的需求尚需激发。

英文摘要：

Objective To explore the social status and interest appeal of rural doctors under essential medicine system. Methods We enrolled 621 rural doctors from 134 village health centers in Shandong Province From August to December, 2012 using multi - stage stratified random sampling method. We collected data,including income of rural doctors before and after the implementation of essential medicine system and income levels of rural teachers and village cadres. Income was taken as a social stratification index to analyze the absolute change of the social status of rural doctors and relative changes compared with reference groups before and after the implementation of essential medicine system. Open - ended questions and qualitative interviews were conducted to investigate the interest appeal of rural doctors. Results A total of 621 questionnaires were distributed,and all questionnaires were returned with an effective returning rate of 100. 0%. After the implementation of essential medicine system,the average yearly income of rural doctors decreased from 22 578. 4 yuan to 13 399. 9 yuan,a decrease of 9 178. 5;the average yearly income of rural doctors was lower than village cadres（16 857. 4 yuan）by 3 457. 5 yuan and was lower than rural teachers（33 932. 7 yuan）by 20 532. 8 - yuan. Younger rural doctors had higher expected yearly income than senior rural doctors〔 ≤30（42 529. 4 ± 21 435. 8）yuan vs. 31 - 45（37 948. 1 ± 17 371. 5） yuan vs. ≥46（34 559. 4 ± 14 720. 2）yuan;P 〈 0. 05 〕. The interest appeals of rural doctors were mainly in the aspects of income （ 86. 8% , 383 / 480）,pension insurance （ 59. 0% ,260 / 480 ）, occupational risk （ 32. 2% ,142 / 480 ） and workload （ 27. 4% ,＆amp;nbsp;121 / 480）;87. 2% （524 / 601）of the enrolled rural doctors hoped that the health centers they served in could become state -run institutions. They didn＇t have strong demand of personal improvement. Conclusion After the implementation of essential medicine system,the income of rural do