陕西省Z县乡村医疗卫生服务实践困境与对策研究  

Research on the Dilemmas and Countermeasures of Rural Medical and Health Service in Z County of Shaanxi Province

作　　者：孙昱童 刘青 尹世龙 杨雨琪 季景玉[2] 吴方[1] Sun Yutong(China Pharmaceutical University,Nanjing,P.R.China)

机构地区：[1]中国药科大学国际医药商学院,江苏南京211198 [2]中国药科大学马克思主义学院

出　　处：《中国卫生事业管理》2025年第3期310-314,322,共6页Chinese Health Service Management

基　　金：国家社会科学基金项目“城乡融合下县域医疗卫生资源配置困境与精准治理研究”(22BGL252)。

摘　　要：目的:探析陕西省Z县乡村医疗卫生服务实践困境,并提出相应的对策,为推动西部欠发达地区同类型乡镇的乡村振兴健康建设提供参考。方法:于2023年7~8月选取陕西Z县乡村医疗卫生服务监管方3人、供给方7人和需求方205人为研究对象,采取半结构式深度访谈、Colaizzi 7步分析法进行资料收集及分析。结果:共访谈215人,提炼出8个副主题并整理归纳为3个主题,获得样本地区乡村医疗卫生服务在“三医协同支撑受限”“分级诊疗效果阻力”“健康管理服务压力”3个维度的实践困境。结论:乡村医疗卫生服务形成受体制机制、资源要素、健康理念等多重影响。建议完善支撑体系以畅通三医协同路径、优化资源配置以提升基层服务效能、内化主动健康以助力体医融合氛围。Objective To analyze the dilemmas of rural medical and health service practice in Z County, Shaanxi Province, and propose corresponding countermeasures, so as to promote the rural revitalization of health construction in the same type of townships in the west underdeveloped areas. Methods 3 people from the supervisory side, 7 people from the supply side and 205 people from the demand side of rural medical and health service in Z County, Shaanxi Province were selected as the research subjects in July-August 2023. Data collection and analysis were conducted through semi-structured in-depth interviews and the Colaizzi 7-step analysis method. Results A total of 215 people were interviewed, and 8 sub-themes were extracted and organized into 3 themes to obtain the results of practice dilemmas in the sample area's rural medical and health service in the 3 dimensions of "limited support for tripartite system reform", "resistance to the effect of tiered diagnosis and treatment system", and "pressure on health management services".Conclusion The configuration of rural medical and health service is influenced by a multitude of factors including institutional mechanisms, resource allocation, and prevailing health ideologies. It is recommended to fortify the support system to facilitate seamless tripartite system reform, optimize resource allocation to bolster the efficacy of grassroots services, and instill a proactive approach to healthcare to foster an environment conducive to physical and medical integration.

关 键 词：乡村卫生 医疗卫生服务 质性研究 

分 类 号：R197[医药卫生—卫生事业管理]