医防融合背景下基层卫生技术人员的培训现状和相关知识需求调查

目的 调查5省基层卫生技术人员医防融合相关培训状况以及相关知识能力的需求状况，为完善我国基层医防融合建设，提高基层卫生服务机构防病治病能力提供参考建议。方法 对五个省15个区县的乡镇卫生院和社区卫生服务中心（站）的卫生技术人员进行分层抽样问卷调查，对调查数据进行描述并对各种医防融合相关知识能力需求进行单因素χ²检验和多因素logistic分析。结果 76.0%的基层卫生技术人员近一年参加过培训，乡镇卫生院卫生技术人员培训参与率（73.2%）低于社区卫生服务中心（站）（84.3%）（χ²= 83.812，P＜0.001），不同特征基层卫生技术人员培训参与率不同（P＜0.01）。各类培训参与率均低于相关知识技能的需求率，公共卫生相关知识技能的需求率最高。χ²检验和多因素logistic分析显示不同特征基层卫生技术人员对各类知识技能的需求率不同:相对于社区卫生服务中心（站），乡镇卫生院人员对传染病防控技能（OR = 0.756，95%CI:0.666～0.858）和一般病与常见病诊疗技能（OR = 0.860，95%CI:0.762～0.971）的需求程度更高；临床医疗岗位人员对传染病防控技能及一般病与常见病诊疗技能、的需求程度更高（P＜0.001）；年轻人员对慢病管理与病因监测技能的需求更高（OR = 0.937，95%CI:0.885～0.992）；公共卫生岗位人员（OR = 1.346，95%CI:1.114～1.626）和专职管理岗位人员（OR = 2.334，95%CI:1.707～3.191）对信息化技能的需求程度更高。结论 应以需求为导向，加强基层卫生技术人员的培训强度，提升培训内容和知识技能需求的匹配程度，建立完善医防交叉培训机制和医防能力兼备的复合型人才培养供给体系。

Survey on the training status and related knowledge needs of primary health technicians in the context of medical prevention integration

Objective To investigate the training status related to the integration of health care and prevention for grassroots health technicians in five provinces and the demand status of related knowledge and ability, and to provide reference suggestions for improving the construction of integration of health care and prevention at the grassroots level in China and improving the ability of grassroots health service institutions to prevent and treat diseases. Methods A stratified sample of health technicians from township health centers and community health service centers (stations) in 15 districts and counties in five provinces was surveyed, and the survey data were described and analyzed by one-way χ²test and multi-factor logistic analysis for the demand of various knowledge and abilities related to medical prevention integration. Results In total 76.0% of the primary health technicians had participated in training in the past year, and the training participation rate of health technicians in township health centers (73.2%) was lower than that of community health service centers (stations) (84.3%) (χ²=83.812, P<0.001), and the training participation rates of primary health technicians differed by characteristics (P<0.01). The participation rate of all types of training was lower than the demand rate of related knowledge and skills, and the demand rate of public health related knowledge and skills was the highest. χ² test and multi-factor logistic analysis showed that the demand rate of various types of knowledge and skills differed among different characteristics of primary health technicians: relative to community health service centers (stations), township health center personnel had different demand rates for infectious disease prevention and control skills (OR=0.756, 95%CI: 0.666-0.858) and general and common disease diagnosis and treatment skills (OR=0.860, 95%CI: 0.762-0.971); clinical medical personnel had higher demand for infectious disease prevention and control skills and general and common disease diagnosis and treatment skills (P<0.001); younger personnel had higher demand for chronic disease management and etiology monitoring skills (OR=0.937, 95%CI: 0.885-0.992); public health post holders (OR=1.346, 95%CI: 1.114-1.626) and allied management post holders (OR=2.334, 95%CI: 1.707-3.191) had a higher demand for information technology skills. Conclusion The training intensity of primary health technicians should be strengthened with demand-oriented, the matching degree of training content and knowledge and skill demand should be improved, and a comprehensive talent training supply system with both medical and defense capabilities should be established and perfected.