乡村医生视角下乡村卫生服务一体化管理推进策略分析  

Analysis of Strategy to Promote Management of Village Township Integration from the Perspective of Village Doctors

作　　者：张艳春 董亚丽 姜巍 秦江梅 张丽芳 林春梅 ZHANG Yan-chun;DONG Ya-li;JIANG Wei(China National Health Development Research Center of National Health Commission,Beijing,100044,China;不详)

机构地区：[1]国家卫生健康委卫生发展研究中心,北京100044

出　　处：《中国卫生经济》2022年第5期51-54,共4页Chinese Health Economics

摘　　要：目的:在村级医疗卫生人员视角下,从机构管理、人员身份、养老保险和意愿4个方面分析乡村卫生服务一体化管理实施进展与推进策略。方法:采用立意抽样方法,在全国30个省(区、市)每个省(区、市)抽取1个典型县(区、市),以抽取县(区、市)内全部村卫生室工作人员为调查对象进行问卷调查;利用统计描述方法进行数据分析。结果:本研究共调查村卫生室工作人员9 587人,约占全国村卫生室人员总数的0.67%。90.52%的村卫生室由乡镇卫生院统一管理;64.71%的被调查人员与乡镇卫生院签订劳动合同,5.53%是卫生院编制职工;59.65%的人员纳入城镇(企业)职工基本养老保险;东部地区村卫生室人员纳入乡镇卫生院统一管理和参加城镇职工基本养老保险的比例显著高于中西部地区。政策建议方面,58.54%的被调查人员建议村卫生室作为乡镇卫生院的派出机构,人财物由乡镇卫生院统一管理;72.40%的被调查人员希望成为卫生院编制职工,23.75%的人员希望成为卫生院合同制聘用人员。结论:乡镇卫生院在村卫生室机构和人员管理中发挥了重要的作用;乡村医生队伍纳入乡镇卫生院管理的意愿较强烈;加强薪酬和养老保障待遇,深入推进乡村卫生服务一体化管理。Objective:Based on the viewpoint of health staff rural clinics, it aimed to analyze the strategies to optimize the management and facilitate sustainable development of village health system and health staff from institution.Methods:With purposive sampling, one typical county(district) was selected from each province(autonomous region, city) of 30 provinces in China mainland, and all the workers from village health clinics in the selected county(district) were selected as the objectives for self-designed-questionnaire survey. Statistical description and case analysis were employed for data analysis.Results:A total of 9 587 health workers in village clinics were investigated, accounting for 0.67% of the total village health staff in China. 90.52% of village clinics were managed by township hospitals. 64.71% village doctors had signed labor contracts with health centers, and 5.53% were staff members of health centers. 59.65% of village doctors were covered by basic pension insurance for workers in cities and towns in terms of the management mode of village clinics, 58.54% of the rural heath workers hoped that village clinics would be a branch of township hospitals, and the personnel and property would be managed uniformly by township hospitals. In terms of personnel status, 72.40% of the staff hoped to become permanent staff of township hospitals, 23.75% of the staff hoped to become contract-based staff of township hospitals.Conclusion:The unified management of rural and township level health facilities has a good foundation. Rural doctors have a strong desire to be managed by township hospitals. It needed to focus on improving salary and social insurance for village doctors, further improve the integration management for rural health services.

关 键 词：乡村医生 乡村卫生服务一体化管理 推进策略 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R197.62