乡村卫生人力资源的执业伦理境况研究  

The Practicing Ethical Status of Rural Health Human Resources

作　　者：彭迎春[1] 王晓燕[1] 黄昊[1] 李珑[1] 

机构地区：[1]首都医科大学卫生管理与教育学院,北京市100069

出　　处：《中国全科医学》2014年第22期2568-2574,共7页Chinese General Practice

基　　金：北京市哲学社会科学规划重大项目(11ZDA05);北京市属高等学校教学创新人才--教学名师项目(PHR201106207);国家软科学研究项目(2010GXS5D179);教育部人文社会科学研究项目(10YJAZH055)

摘　　要：目的了解乡村卫生人力资源的生存境遇及执业伦理状况。方法于2011年5月26—28日,采用分层随机抽样方法,在北京市抽取M、C、D、F、T 5个区县的25个乡镇的75个行政村进行现场调研,采用问卷调查5类利益相关者:乡镇卫生院管理者、乡镇卫生院医务人员、村医、村民、村干部共计1 719人,调查内容包括农村卫生人力资源的配置现状、机构设置状况、卫生服务提供情况、村民卫生服务需求状况等。同期在5个区县采取目的抽样法,访谈各类关键知情人:区县政府主管卫生的领导、卫生行政部门管理者、乡村医务人员和村民共计35人,访谈内容包括农村卫生人力资源配置中存在的问题、原因分析、完善的对策与措施建议等。结果对于乡村医务人员的诊治能力,有70.3%的村医认可自己的诊治能力、有50.8%的村民认为村医完全能解决或解决较多村民常见疾病的诊治问题;有58.7%的乡镇卫生院医务人员认可自己的诊治能力、有33.7%的村民认为乡镇卫生院医务人员完全能解决或解决较多村民常见疾病的诊治问题。1 134名村民中,有965人(85.1%)对村医的服务表示满意,仅有53人(4.7%)表示不满意。对于村医在农村医疗卫生中所起的作用,1 139名村民中有490人(43.0%)认为作用比较大,有330人(29.0%)认为作用很大。1 136名村民中,有477人(42.0%)表示自己对村医比较信任,有316人(27.8%)表示完全信任村医。1 139名村民中,有601人(52.8%)认为村医在村中比较受尊重,有252人(22.1%)认为村医在村中非常受尊重。1 137名村民2010年药品、医疗服务及用品支出平均为5 884.22元,占生活消费性支出的33.0%,占家庭年纯收入的23.6%。结论乡村两级卫生人力为村民提供不同内容的医疗卫生服务,他们的道德、技术获得了不同的认可度。村医在乡土社会更易获得村民的认可。乡村卫生人力资源的配置需考虑乡土社会的情�Objective To investigate the practicing ethics status of rural health personnel. Methods A total of 1 719 stakeholders were questioned with 35 key informants interviewed by stratified sampling in 75 villages and 25 towns of the five dis-tricts in Beijing in 26 - 28 May 2011. Results With regards to the ability of rural medical personnel to perform diagnosis and treatment,70. 3% of village doctors consider themselves,while 50. 8% of the villagers believe the village doctors can completely solve or resolve many diagnostic and treatment problems of common diseases;58. 7% of the township hospital medical staff con-sider themselves,while 33. 7% of the villagers believe township hospital medical staff are fully able to solve or resolve diagnostic and treatment problems of common diseases. Of 1 134 villagers,965（85. 1% ）eXpressed satisfaction with the village doctorˊs services;only 53（4. 7% ）were dissatisfied. For village doctors in rural health care,490（43. 0% ）of 1 139 villagers believe that the role is relatively large;330 people（29. 0% ）think they play a large role. 477（42. 0% ）of 1 136 of villagers were likely to trust the village doctor;316（27. 8% ）eXpressed full confidence. 601（52. 8% ）of 1 139 villagers believe that the village doc-tor is respected;252（22. 1% ）believe that the village doctor is very respected in the village. Drugs,medical services,and sup-plies cost an average of 5 884. 22 yuan, accounting for 33. 0% of living eXpenses, or 23. 6% of household net in-come. Conclusion Different health services are provided by village doctors and township personnel. Different degree of recogni- 〈br〉 tion of moral and ethical was reported by villagers. Village doctors were more likely to be recognized in rural areas. The local social conteXt should be fully considered when allocating rural health personnel.

关 键 词：农村卫生 卫生人力 伦理 

分 类 号：R19[医药卫生—卫生事业管理]