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上海市乡村医生及其服务模式改革研究背景和主要结果简介

期刊名称：中国初级卫生保健
时间：0
页码：4-6
语言：中文
分类：R197[医药卫生—卫生事业管理;医药卫生—公共卫生与预防医学]
作者机构：[1]上海市卫生局,上海200040, [2]复旦大学卫生发展战略研究中心,上海200032, [3]中华预防医学会公共卫生管理分会基层公共卫生管理学组,上海201800
相关基金：基金项目：国家自然科学基金重点项目（70733002）;国家自然科学基金青年项目（70703005）;国家社会科学青年基金项目（08CZZ022）;上海市卫生局科研基金资助项目：“长江学者特聘教授”项目基金：复旦大学公共管理与公共政策研究国家哲学社会科学创新基地基金.
相关项目：医疗改革中的社会均衡与政策研究

关键词：乡村医生, 现状, 服务内容, 改革, rural doctor, status in quo, service content, reform

中文摘要：

采用现况调查、意向调查等方法,旨在明确上海市乡村医生队伍、服务模式和服务内容能否满足新形势的需要;优化上述三方面所需的策略选择及支持系统,为上海市乡村医生服务的进一步改革提供科学的依据。围绕研究目的,调研上海市宝山、嘉定、闵行、松江、青浦、南汇、奉贤、崇明8个郊区（县）24个乡镇72个样本村。项目的主要研究结果：（1）村医存在人力数量相对不足,老龄化,职称、学历等素质偏低和收入偏低等问题;（2）村医服务效率偏低,服务时间仅占8小时的50.0%左右,存在着严重“重医轻防”现象;（3）每天每村医上门服务0.6次,上门服务方式保持良好,但上门服务的可及性有待提高;（4）村医服务基本满足农村居民需求,农村居民满意程度达到了98.3%;（5）实行乡村一体化管理,对村医实施培训,随着较低素质村医不断退休,使之正规化是比较理想的模式（98.3%被调查者认可）;（6）随着初中及其以下学历者的退休,不断补充正规医学教育和培训者实现替代需要19年,每乡镇卫生院需承担年出诊次数为3595次;为提高村医收入和保障水平,需在现行村医人员经费基础上,增加投入7700.2万元。

英文摘要：

The paper aimed to discover what’ s going on rural doctors and their service in Shanghai of China presently, if did their service meet to Shanghai People’ s need, and what are the content, model, and supporting policy and system of their service if normalizing rural doctors gradually so as to play a role during making a correlative reform. In order to realizing this objective, the study surveyed 8 districts, including Baoshan, Jiading, Minghang, Songjiang, Qingpu, Nanhui, Fengxian and Chongming, 24 towns and 72 counties. The discover included：（1）There were several problems, such as shortage quantitatively, aging, lower quality and income of rural doctors in Shanghai of China; （2） Lower service efficiency, about 50% of 8 hours a day, and paying more attention on medical service than disease prevention and control by rural doctors; （3） Visiting a patient at home 0.6 times every day every rural doctor, this good service model of visiting patients were kept, however, the accessibility of this service should be improved. （4） 98.3%of surveyed residents satisfied rural doctors＇ service and felt that their need was met. （5） Putting in practice the policy of integrated management town and village health organizations, training rural doctors, substituting them for doctors with higher quality with their retiring, and making them normalized were better ideal reform model, 98.3% of health organizers and providers approved. （6） With rural doctors retiring, substituting them for doctors with higher quality and educated formally needed 19 years and every town hospital need shoulder visiting a patient at home 3 595 times every year. 77 002 000 Yuan were increased to improve the rural doctors＇ income and social insurance.

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