河北省乡村医生公共卫生服务情况及影响因素  

Village doctors-supplied public health service and its influencing factors in rural areas of Hebei province

作　　者：米术斌[1] 王经纬[1] 马超[1] 梁莉[1] MI Shu-bin;WANG Jing-wei;MA Chao(Chengde Medical College,Chengde,Hebei Province 067000,China)

机构地区：[1]承德医学院

出　　处：《中国公共卫生》2019年第6期689-692,共4页Chinese Journal of Public Health

基　　金：2014年河北省教育厅人文社会科学研究重大课题攻关项目(项目批准号:ZD201432);2013年北京大学医学部中美医师职业精神研究中心资助项目(PUHSC-MPC1303)

摘　　要：目的了解河北省乡村公共卫生服务情况,分析公共卫生服务开展不平衡的原因,为乡村公共卫生服务发展和均等化提供建议和意见。方法2011年采用多级抽样的方法从河北省抽取5个市、10个县、20个乡镇共800名乡村医生进行问卷调查,了解基本情况、2011年实施的基本公共卫生服务、公共卫生责任,并进行评分和比较。结果基本公共卫生服务平均得分率为76.59%(68.25%~80.75%),慢病管理得分最高为(3.25±0.73)分,中医药辨识最低为(2.73±1.07)分。不同年龄、地区、有无执业(助理)医师证书间存在差异(P<0.05)。logistic回归分析得出年龄、地区、学历、有无执业(助理)医师证书是公共卫生责任意识的主要影响因素。结论开展基本公共卫生服务不平衡,卫生服务得分不高;应加强乡村医院建设和人员培训,转变观念,完善卫生服务规范,加大经费投入,合理分配资源,加强基本公共卫生服务宣传,促进公共卫生服务均衡发展和提高。Objective To explore the status and causes of imbalance of public health service (PHS) supplied by village doctors in rural areas of Hebei province for making suggestions to development and equalization of PHS in rural areas.Methods Using a self-designed questionnaire, we carried out a survey among 800 village doctors recruited with multistage random sampling in 20 towns of 10 counties of 5 municipalities in Hebei province in 2011. Information on basic PHS provided by the village doctors and PHS-related responsibilities of the village doctors were collected, evaluated, and compared.Results Of all the village doctors, 732 (91.5%) completed the survey. The average scoring rate for 11 basic PHS items ranged from 68.25% to 80.75%, with an average overall scoring rate of 76.59%. Among the basic PHS items provided by the village doctors, the management on chronic disease was graded the highest score of 3.25 ±0.73 (scale of 0-4) and the identification of Chinese medicinal materials was graded the lowest score of 2.73 ±1.07. The score for basic PHS items differed significantly by geographical region, the village doctors' age and whether a village doctor being certificated as a practicing physician or an assistant practicing physician (P < 0.05 for all). Logistic regression analyses indicated that a village doctor's sense of responsibility for performing basic PHS was mainly influenced by the doctor's age, geographical region, education, and whether being certificated as a practicing physician or a assistant practicing physician.Conclusion In rural areas of Hebei province, the basic public health service is not evenly performed by village doctors and the evaluation score for public health service is relatively low. The results suggest that measures should be taken to improve the public health service supplied by village doctors for the promotion and equalization of basic public health service.

关 键 词：乡村医生 公共卫生服务 研究 

分 类 号：R197[医药卫生—卫生事业管理]