农村社区开展全科医学培训的实践与思考

当前开展农村社区卫生服务工作,最大的困难就在于农村基层医务人员缺少全科医学知识,因此,加速培训合格的全科医学人才,以尽快适应开展农村社区卫生服务的需要,就成为农村卫生工作的当务之急。江苏省盐城市卫生局为提高农村社区卫生人员从事社区卫生服务的综合能力,有计划地对现有人员进行全科医学培圳。1998年底在盐部县大风镇和射阳县兴桥镇的农村开展全科医学培训的试点,现就试点地区3年多来在农村开展合乎医学培圳的实践及其问题的思考简述如下。     

招远市全科医学与农村社区卫生服务模式的探讨

如何运用全科医学，在农村开展社区卫生工作，为农村居民提供良好的卫生保健服务，这是市场经济条件下广大农村迫切需要解决的问题。山东省招远市１９９４年开始组建全科医学职业中专，实施以社区为范围、以家庭为单位、以个人为中心的农村社区卫生服务，探索了适应我国国...     

在农村开展全科医学培训的实践与思考

当前开展农村社区卫生服务工作,最大的困难京在于农村基层医务人员缺少困难就在农村基层医务人员缺少全科医学知识,因此,加速培养合格的全科医学人才,以尽快适应开展农村社区卫生服务的需要,就成为农村卫生工作的当务之急,江苏省盐城市卫生局为提高农村卫生从事社区卫生服务的综合能力,有计划地对现有人员进行全科医学培训,１９９８年底在盐盐县大冈镇和射阳县兴桥镇的农樯开展全科医学培训的试点,现就试点地区３年多来在农村开展全科医学培训的实践及其问题的思考简述如下。     

上海市某社区全科医学教学师资建设探索

随着医学教育改革的不断深入,全科医学的发展愈发受到重视,参与全科医学教学的社区卫生服务中心逐渐增多,社区的全科医学教学工作得到了极大推进,但社区全科医学教学师资队伍建设尚无统一标准,难以保证全科医生的质量.文章以上海市浦东新区花木社区卫生服务中心的全科医学教学师资建设为例,分享社区全科医学教学师资培养的经验,探索社区全...     

探索乡镇社区卫生服务可持续发展的长效机制

目的:探讨乡镇社区卫生服务工作可持续发展的长效机制,分析边远乡镇社区卫生服务工作实践的侧重面。方法:以开化县杨林镇社区卫生服务中心为实例,讨论乡镇社区卫生服务工作实践的要点,分析工作效益。结果:提升服务理念,乡镇社区卫生服务工作"六位一体"有机结合,实施全科医学模式,效益良好。结论:坚持政府主导,强化人才队伍建设,不断改革创新,提升乡镇社区卫生服务工作质量,促进乡镇社区卫生服务工作走上全面、协调、可持续发展的道路。     

全科医师骨干培训大纲

一、培养目标遵循以全科医学的基本理论为指导,社区卫生需求为导向,实践、思考、学习为方法,培养全科医师的综合服务能力为目标,通过较为系统的全科医学及相关理论、临床和社区实践技能培训,培养学员热爱、忠诚社区卫生服务事业的精神,掌握全科医疗的工作方式,全面提高其对社区常见病多发病的诊断、鉴别诊断、转诊、预防保健和健康教育技能,具有一定的社区卫生服务组织管理能力,达到全科医师骨干的基本要求,成为社区卫生服务队伍中的业务骨干人才。     

社区卫生服务机构开展科研的思考简

在肯定“社区医生要开展科研”基础上,具体阐述社区卫生服务机构及医务人员为什么要做科研和社区卫生科研能进行哪些方面的研究,并指出社区卫生开展科研具有研究内容与方法上的先天优势,应转换思维,跳出临床医学的框架,在自然科学与人文社会科学交叉融合的全科医学领域内开展社区卫生科研。     

社区卫生服务机构开展科研的思考

在肯定"社区医生要开展科研"基础上,具体阐述社区卫生服务机构及医务人员为什么要做科研和社区卫生科研能进行哪些方面的研究,并指出社区卫生开展科研具有研究内容与方法上的先天优势,应转换思维,跳出临床医学的框架,在自然科学与人文社会科学交叉融合的全科医学领域内开展社区卫生科研。     

金科医生与农村社区卫生服务

1 培养全科医生是开展社区卫生服务的前提全科医学是以传统生物医学整合的心理与行为医学和社会学及其他相关科学理论而形成的一个新型医学体系,与内科、外科、妇产科、儿科等学科并列为二级学科.有人认为,过去的乡村医生本身就是全科医生,其从事的工作就是社区卫生服务,这种观点是片面的.只有接受了全科医学教育,才能成为全科医生."全科”的含义是指在社区进行医疗、预防、保健、康复等工作,是不分科的.全科医学的理论体系和实践服务要求全科医生是对全人、全科、全程、全生命用全心进行服务.全科医生整体队伍状况成为影响社区卫生服务的主要因素.     

全科医学本科社区实践基地研究与实践

本科教育阶段建设全科医学社区实践基地有利于转变学生医疗理念、树立全科医学思维,也有利于培养学生社区卫生服务能力。温州医科大学以为各地政府培养定向社区医学人才的天然联系为纽带,通过校地共建方式,进行全面标准化建设,并实施特色发展,以远程协作方式开展全科教学,在省内26所社区实践基地开展试点研究与实践,正逐步建设完成交互式多媒体诊断实验室,实现体检与诊断的远程教学共享。     

The planning of rural health research: rurality and rural population issues

Rurality and rural population issues require special consideration when planning both qualitative and quantitative health research in rural areas. The objective of this article was to explore the issues that require attention when planning the research. This is the first of two articles and focus on issues that require consideration when undertaking rural health research. The diversity of study populations, the feasibility of a research topic, the selection of a research team, and the cultural traditions of Indigenous communities, are all aspects of rural health research planning that require attention. Procedures such as identifying the characteristics of the population, the selection of measures of rurality appropriate for the research topic, the use of local liaison persons, decisions on the use of 'insider' or 'outsider' researchers, and the identification of skills resources available, increase the quality of the research outcomes. These issues are relevant to both qualitative and quantitative research. Procedures are available to address issues of particular concern in developing appropriate methods for rural health research. While we have concentrated on Australian issues and solutions, rural localities in other countries may face similar issues. Attention to rurality and rural situations when planning rural health research, results in studies that support the continued improvement of health in rural communities.     

农村公共卫生服务体系绩效评价指标在农村卫生改革中的实践

目的:评价中国农村卫生发展项目(简称"卫十一项目")实施期间,项目地区公共卫生服务体系的绩效。方法:采用项目开发的农村公共卫生服务绩效评价指标体系,连续收集40个项目县2008—2013年的投入、产出指标,进行综合分析与评价。结果:项目地区2008—2013年间公共卫生的投入和产出均逐年提高,分别由项目初期的22.73分和39.05分增加到32.62分和57.60分,增幅达43.15%和47.50%,部分项目省份投入增幅较产出明显。项目地区投入产出比从1.72增加到1.77,年间略有波动。结论:采用公共卫生服务体系绩效考核指标监测项目实施进程,有利于及时发现农村公共卫生服务体系建设中存在的薄弱环节,从而针对性地采取有效措施促进体系的完善。在加大公共卫生投入的时候,如何高效利用资源,提高服务效果依然是亟需解决的问题。     

Key considerations in delivering appropriate and accessible health care for rural and remote populations: Discussant overview

Objective:  To provide an overview of papers discussing optimal service delivery models for rural and remote Australia.
Design:  A synthesis of overarching considerations guiding rural and remote health service policies.
Setting:  Small rural and remote communities in Australia.
Participants:  Invited delegates attending the Inaugural Rural and Remote Health Scientific Symposium in Brisbane 2008.
Main outcome measures:  Key issues underpinning health service provision for small rural and remote communities.
Results:  The formulation and implementation of effective health service provision policies must be underpinned by overarching health goals, agreed health service requirements, recognition of how rural and remote health contexts impact upon health service provision and the constraints limiting health service responses.
Conclusion:  Systemic change is required in order to ensure equitable access to health care services in small rural and remote communities.     

乡村振兴背景下乡村基层全科医生人才培养策略探讨

“健康乡村建设”是乡村振兴战略的重要内容,其实施的关键为加强乡村基层全科医学人才队伍建设。文章立足于乡村百姓卫生健康服务实际需求,针对乡村基层全科医学人才培养,建议既要全面落实、用足用好乡村全科人才激励政策,又要紧密围绕临床规范诊疗、急诊应急、亚专长能力培养、公共卫生、心理健康、中医药服务等领域全力提升乡村全科医生卫生健康专业服务水平,同时还要持续增强乡村全科医生人文素养、沟通协调、政策解读等综合管理服务能力。通过上述举措,着力培养一支“未病善防,小病善治,大病善识,急病善转,慢病善管”的防治结合、复合型乡村全科医学人才队伍,切实发挥乡村全科医生“健康乡村建设”主力军的作用。     

Rural health care in Malaysia

ABSTRACT:   Malaysia has a population of 21.2 million of which 44% resides in rural areas. A major priority of healthcare providers has been the enhancement of health of 'disadvantaged' rural communities particularly the rural poor, women, infants, children and the disabled. The Ministry of Health is the main healthcare provider for rural communities with general practitioners playing a complimentary role. With an extensive network of rural health clinics, rural residents today have access to modern healthcare with adequate referral facilities. Mobile teams, the flying doctor service and village health promoters provide healthcare to remote areas. The improvement in health status of the rural population using universal health status indicators has been remarkable. However, differentials in health status continue to exist between urban and rural populations. Malaysia's telemedicine project is seen as a means of achieving health for all rural people.     

The health service needs of small rural communities

ABSTRACT: In recent years econometric models used in health service planning have tended to encourage the downgrading or closure of small rural hospitals with the effect of reducing access to services and transferring costs from health authorities to consumers. These changes have occurred despite mounting evidence that people in rural communities have specific health service needs which require special attention. This study aimed to identify the perceptions of community members, health professionals and administrators regarding the health service needs in their small rural communities as a basis for developing a more comprehensive model of rural health service planning. Focus groups were held in three selected towns in Gippsland, exploring participants' perceptions of the meaning of health, health service needs, impact of health services, and the best set-up for health services. Consistent with previous research, key findings include: a broad conceptualisation of health; the perceived overwhelming importance of doctors, hospitals and chemists; the economic and social importance of a rural hospital; and a preference for all health services being provided under the one roof, funding and program flexibility, and local involvement in health service planning and implementation.     

县级基本公共卫生服务项目质量监督与控制模式研究

卫生项目质量是项目执行与管理的生命线。文章以县级基本公共卫生服务项目为典型,通过对东部地区的江苏丹阳、中部地区的河南息县和西部地区的重庆九龙坡等县级项目的运行与质量管理现状进行调查,分析总结了项目质量监督与控制的主要方法。并结合相关理论与实践,初步构建了项目质量监督与控制模式。     

农村基层医疗卫生机构绩效管理探索——以甘肃省会宁县为例

甘肃省会宁县结合世界银行贷款,英国政府赠款中国农村卫生发展项目（简称卫生XI项目）,以推行乡村卫生机构绩效考核为突破口,以提高乡村卫生机构服务质量为核心,对全县所有乡村卫生机构实施了绩效考核和质量评价,并将考评结果应用于绩效支付等管理中,有效地改善了乡村卫生机构的服务质量与水平。对此项工作进行了总结,并重点探讨了实施过程及实施效果。