构建我国农村援助医疗模式及其实施条件的循证探索

目的 针对我国“看病贵、看病难”这一社会热点问题，分析我国农村和基层地区缺乏合格卫生人力资源的现状和原因，结合现有政策体系提出解决方案。方法 借鉴循证医学的理念和方法，根据研究目的制定严格的文献纳入和排除标准，系统收集来源于PubMed和CNKI数据库和各国政府与卫生行业相关官方网站中的各类文献、文件和资料，进行分类、分级，并提取相关政策、证据信息，综合分析后给出解决方案，而后再对此方案开展问卷调查，根据调查结果校正解决方案，给出政策建议。文献检索时间截至2006年11月。结果 最终纳入中文文献147篇，英文文献30篇，检索相关官方网站23个。综合纳入文献资料的信息，在我国解决基层地区合格卫生人力资源的现有政策框架内，提出“住院医师援助医疗模式”的解决方案。再针对该模式，对高层领导、兰州地区医学生和医学院教职工进行问卷调查，结果显示，85％以上被调查者认为该模式可行或可能可行。认为不可行因素中最重要的是政府没有相关政策。结论 根据上述研究和现场调查的结果，建议政府出台相关政策，选点试行援助医疗模式，在实践中发现并解决新问题。

Construction of China''''s Rural Medical Assistance Model: An Evidence-based Approach

Objective In light of problems related to the accessibility and affordability of healthcare,we aimed to investigate the status and causes for the shortage of qualified health human resources in the rural and primary health care setting,and to propose solutions to these problems at the level of health policy system.Methods The principles and methods of evidence-based medicine were applied.We developed the study selection criteria on the basis of the proposed questions,and identified relevant literature from biomedical databases and other additional sources.We graded eligible studies,extracted data,and summarized the data to draw conclusions.In addition,we conducted a survey to refine the proposed solutions.Results We identified 147 studies from PubMed and CNKI,of which 30 were in English.After summarizing the information,and using knowledge about the human resources for health in primary healthcare in China,we proposed a model of resident doctor aid healthcare.The survey that we conducted to assess such a model included interviewees of top level policy makers,medical students and staff in medical universities.Most of the interviewees(85%) thought it was feasible to develop an aid healthcare system.Among those who disagreed,the lack of corresponding policy was the most common factor.Conclusions It is suggested that the government develop relevant policies and make an attempt to practice the aid healthcare system.Emerging problems could be identified and addressed in practice.