| 引用本文：朱坤, 乔学斌, 张小娟, 田淼淼.乡村医生签约服务实践分析——以江苏省大丰市和浙江省嵊州市为例[J].中国卫生政策研究,2015,8(12):60-66 |
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| 乡村医生签约服务实践分析——以江苏省大丰市和浙江省嵊州市为例 |
| 投稿时间：2015-10-29 修订日期：2015-11-20 PDF全文浏览 HTML全文浏览 |
| 朱坤1, 乔学斌2, 张小娟1, 田淼淼1 |
1. 中国医学科学院医学信息研究所 卫生政策与管理研究中心 北京 100020;
2. 盐城卫生职业技术学院 江苏盐城 224005 |
| 摘要:目的:分析江苏省大丰市和浙江省嵊州市乡村医生签约服务实践及其初步成效。方法:采用典型抽样,对江苏省大丰市和浙江省嵊州市卫生局的局长或分管局长、乡镇卫生院的院长、乡村医生进行访谈,对访谈内容和政策文件进行归纳,对签约服务前后的服务量变化进行描述性分析。结果:大丰和嵊州乡村医生签约服务以村卫生室和乡镇卫生院为主体,面向全体居民并侧重重点人群,因地制宜地设计了不同的个性化服务包,并建立了相应的保障措施和激励机制。结论:通过签约服务,满足了群众的个性化需求;乡村医生收入增加,积极性提高,农村卫生服务网底得到巩固;基本公共卫生服务质量有所改善;基层医疗卫生机构基本医疗功能得到进一步强化;乡村医生签约服务助推了农村卫生改革,为地方制定和完善农村卫生改革政策提供了依据,但仍需进一步完善。建议:加强乡村医生队伍建设;完善乡村医生签约服务的激励机制;加强对乡村医生签约服务工作的总结评估,为进一步推广签约服务提供依据。 |
| 关键词:乡村医生 签约服务 农村卫生 激励机制 分级诊疗 |
| 基金项目:国家自然科学基金(71573276) |
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| Analysis on the rural doctors' contracted service practice in Dafeng county of Jiangsu province and Shengzhou county of Zhejiang province |
| ZHU Kun1, QIAO Xue-bin2, ZHANG Xiao-juan1, TIAN Miao-miao1 |
1. Center for Health Policy and Management, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China;
2. Yancheng Vocational Institute of Health Science, Yancheng Jiangsu 224005, China |
| Abstract:Objectives: The paper aims to analyze the practice and outcome for the rural doctors' contracted service in Dafeng and Shengzhou counties. Methods: The methods used were typical sampling which played in selecting Dafeng and Shengzhou counties and interviews conducted with the director of the bureau of health in Dafeng and Shengzhou counties, the dean of the township health centers (two for each county) and the rural doctors (four for each county). We adopted descriptive statistics to analyze the quantitative data and incentives. Results: The rural clinic and/or township health centers were the main contracted service providers and services were supplied to all inhabitants, especially to the target patients such as those suffering from NCDs. The individual benefit packages were designed to coordinate with local demands and the security and incentive mechanisms were established. Conclusions: Contracted service brought several benefits such as meeting the individual demands of inhabitants, rural doctors were inspired and the basic rural health system consolidated, the basic public health service quality was improved, and the function was intensified for the primary health institutions. The rural doctors' contracted service is helpful to advance rural health care reforms, and provides more evidence in setting up the local rural health policies. It still needs further perfections. Suggestions: The rural doctors' team construction should be strengthened and the incentive mechanism, summary and evaluation of their contracted service should be improved timely. |
| Key words:Rural doctors Contracted service Rural health Incentive mechanism Classified diagnosis and treatment |
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