我国农村医生社区健康管理能力调查研究  

Investigation on Community Health Management Ability of Rural Doctors in China

作　　者：谢坤 王萱萱[2] 李思清 高淑红 陈家应 张朝阳 XIE Kun;WANG Xuanxuan;LI Siqing;GAO Shuhong;CHEN Jiaying;ZHANG Zhaoyang(Kangda College of Nanjing Medical University,Nanjing 222000,China;School of Health Policy ang Management,Nanjing Medical University,Nanjing 211116,China;School of Continuing Education,Nanjing Medical University,Nanjing 211116,China;China Rural Health Association,Beijing 100061,China)

机构地区：[1]南京医科大学康达学院,江苏省连云港市222000 [2]南京医科大学医政学院,江苏省南京市211116 [3]南京医科大学继续教育学院,江苏省南京市211116 [4]中国农村卫生协会,北京市100061

出　　处：《中国全科医学》2024年第34期4308-4314,4321,共8页Chinese General Practice

基　　金：国家自然科学基金资助项目(71874087);中国-盖茨基金会农村基本卫生保健项目(OPP1176308);江苏高校哲社科研究一般项目(2023SJYB1837)。

摘　　要：背景农村医生(以下简称村医)作为农村地区居民的健康“守门人”,是农村人群健康管理服务的主要提供者,其社区健康管理能力直接影响农村居民的健康水平。目的调查我国村医健康管理能力现状,探讨村医社区健康管理能力提升策略,为加强村医队伍建设提供依据。方法于2020年8月,采用多阶段分层整群抽样和典型抽样相结合的方法,在全国东、中、西部5个省份共抽取村医3916名。通过“问卷星”平台向村医发放调查问卷,内容涉及村医的儿童、妇女、老年人、慢性病患者健康管理能力具备情况,以及各项能力满足工作需要情况,均由村医自评。结果3916名村医中,分别有3494名(89.22%)、3175名(81.08%)、3775名(96.40%)、3738名(95.45%)村医具备儿童、妇女、老年人、慢性病患者的健康管理能力。性别方面,女性村医的计生指导、孕期健康指导、围绝经期疾病的预防与诊治、妇科常见病筛查能力及妇女总体健康管理能力具备率高于男性村医(P<0.05);男性村医的常见慢性病危急状况识别与处理方法、常见慢性病稳定期治疗与并发症预防能力及慢性病患者总体健康管理能力具备率高于女性村医(P<0.05)。执业资质方面,执业(助理)医师的围绝经期疾病的预防与诊治能力具备率高于乡村医生和其他/无资质的村医(P<0.0083),执业(助理)医师村医的妇女总体健康管理能力具备率高于乡村医生(P<0.0083);全科医师的老年人功能减退预防能力具备率高于乡村医生(P<0.0083)。学历方面,本科及以上者的常见慢性病稳定期治疗与并发症预防能力具备率高于大专学历者(P<0.017)。东部地区村医的体检指导与常见病筛查能力满足实际工作需要率高于中部、西部地区,中部地区高于西部地区(P<0.017);东部、中部地区村医的健康与自理能力评估、不良情绪识别与干预、功能减退预防能力满足实际工作需�Background As the gatekeepers for rural management services for rural populations.Their community health management ability directly affects the health level of rural residents.Objective This study aims to investigate the current status of health management ability of rural doctors in China and explore strategies for enhancing their community health management ability,thus providing a basis for strengthening the building of a rural doctor team.Methods In August 2020,a multi-stage stratified cluster sampling and purposive sampling methods were used to select 3916 rural doctors from five provinces in east,central,and western China.Rural doctors were surveyed using an online questionnaire platform called"Wenjuanxing".The questionnaire content included the rural doctors'ability to manage the health of children,women,elderly,and chronic disease patients,and the degree to which these needs were met,all of which were self-evaluated by the rural doctors.Results Of the 3916 rural doctors surveyed,3494(89.22%),3175(81.08%),3775(96.40%),and 3738(95.45%)were found to had the ability to manage the health of children,women,the elderly,and patients with chronic diseases,respectively.The ability of female rural doctors to provide family planning guidance,prenatal health guidance,prevention and treatment of menopause-related diseases,and screening for common gynecological diseases was better than that of male rural doctors(P<0.05);while the male village doctors had a higher rate of identifying and handling common chronic disease critical conditions,stable and regular treatment of common chronic diseases,prevention of complications,and health management abilities for chronic disease patients compared to female village doctors(P<0.05).Rural doctors with qualifications of medical practitioners or assistant medical practitioners had a higher proportion of those with the ability to prevent and treat menopause-related diseases than those with qualifications of rural practitioners and other qualifications(P<0.0083).Rural doctors with qu

关 键 词：乡村医生 乡村卫生服务 健康管理 临床工作能力 公共卫生服务 

分 类 号：R127[医药卫生—环境卫生学]