市场经济体制下构建农村卫生服务体系研究

目的探索构建新型农村卫生服务体系的途径与方法.方法对南通市3个县(市)的所有乡镇(中心)卫生院、卫生所(防保科)和县级卫生机构负责人进行定量与定性调查相结合方法调查.结果通过乡镇卫生院产权制度改革、以政府办独立卫生所或政府向民营乡镇医院购买防保服务的形式向农村居民提供公共卫生服务、以多元化的投资建立村级社区卫生服务站等形式,重新构建了南通市农村卫生服务体系.结论农村卫生服务体系中,乡镇医院的经营状况在好转,农村社区卫生服务体系的建立与完善尚依赖于政府对民营乡镇医院采取有效的管理与协调措施,独立卫生所在公共卫生服务、农村卫生管理方面的工作优于政府购买公共卫生服务的形式.

Study on Structuring New Rural Health Service System under the Market Economy

Objectives Exploring the ways and methods to structure new rural health service system. Methods A combination of quantitive and qualitative methods adopted to survey all township health centers (THC) , township public health centers (TPHC) and the leaders of county health facilities in 3 counties of Nantong. Results The newly established heslth service system in rural Nantong is privatizing THC property right, public-owned TPHCs providing public health services or local government purchasing public health for residents from privatized THCs , and setting rural community health stations invested by multiple owners including private. Conclusion In the new system, privatized THCs are total getting better operation, but structuring and improving rural community health service system mostly rely on effective administration and coordination to those THCs by local government . And independent TPHCs work better than government purchasing services in public health services provision and rural health administration.