中国村卫生室医疗卫生服务能力的现状、问题及对策

目的:分析评价我国村卫生室医疗卫生服务能力的现状和问题,为制定政策提供参考和依据。方法:对东部(北京、江苏、山东、福建、广东)、中部(黑龙江、河南、湖北)以及西部(四川、贵州、云南、西藏、陕西、新疆)共14个省(区、市)的1 683位医疗机构法人代表或者法定代表人、14 131位医务人员、12 316位城乡居民以及10 473名乡村医生进行问卷调查;分小组对福建、广东、贵州、河南、江苏、山东、云南、湖南、四川9个省实地调研,通过实地观察、开展座谈和蹲点访谈获取一手资料。结果:全国范围内村卫生室条件总体上明显改善,服务能力有所提高,但也普遍存在标准化达标率地区差距大、医疗服务水平能力偏低、公共卫生服务质量不高、缺药少药与过度用药并存等突出问题。结论:通过实施加大对医疗贫困地区财政扶持力度等政策提高村卫生室医疗卫生服务能力仍是当务之急。

Analysis on the current status, problems and countermeasures of medical service capabilities in the Chinese village clinics

Objective:To analyze and evaluate the current status, problems and countermeasures of the medical service capabilities in the Chinese village clinics, and provide reference and basis for policy making. Methods:During data collection, different regions of China were focused and sampled as follows:in the eastern region, Beijing, Jiangsu, Shandong, Fujian, and Guandong were sampled; in Central, Heilongjiang, Henan and Hubei were considered; while in the western region, Sichuan, Guizhou, Yunnan, Tibet, Shaanxi, and Xinjiang were concerned. A total of 1683 legal persons in medical institutions, 14131 medical personnel, 12316 urban and rural residents as well as 10473 rural physicians in 14 provinces abovementioned (autonomous regions and municipalities) were selected as respondents to the self-made questionnaire that was used. To obtain first-hand information through field observation, seminars and interviews, field surveys were conducted in groups in 9 provinces of Fujian, Guandong, Guizhou, Henan, Jiangsu, Shandong, Yunnan, Hunan, and Sichuan. Results:The conditions and the services of the village clinics are generally improved countrywide. However, there are still many prominent problems such as the large regional gap in standardization, poor medical services, poor quality of public health services, and lack or overuse of drugs, together with other outstanding issues. Conclusion:It is imperative to improve the medical services capacities in village clinics through the implementation of policies such as increase of financial support for areas with poor medical service provision due to lack of efficient medical institutions, quality professionals or competent medical personnel etc.