村卫生室人员执业现状及待遇保障分析——基于6省18县的调查

 
投稿时间: 2015-08-31  最后修改时间: 2015-10-16  摘要点击次数: 2587  全文下载次数: 5
 
引用本文:张小娟, 田淼淼, 朱坤.村卫生室人员执业现状及待遇保障分析——基于6省18县的调查[J].中国卫生政策研究,2015,8(11):63-69
张小娟, 田淼淼, 朱坤
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
基金项目:国家卫生和计划生育委员会委托项目
 
 摘要:目的:分析村卫生室人员执业现状及待遇保障情况。方法:根据经济社会发展水平抽取6省18县(市/区),利用自制调查表调查18县下辖的全部村卫生室。结果:每千农村人口村卫生室人员均数0.7~1.9人;每村卫生室人员均数为1.36~3.24人;部分省村卫生室60岁人员占比超过20%;50%以上村卫生室人员学历为中专且仅有乡村医生执业证书;西部2省村卫生室人员医疗责任险覆盖比例低于11%;除江苏外,其他5省村卫生室人员主要参加新农村养老保险;江苏每村卫生室人员公共卫生和基药补助最高,福建省最低;纳入乡镇卫生院编制管理的村卫生室人员占比低于20%;除江苏外,70%以上村卫生室人员提供24小时服务;村卫生室流出人员超过新进人员。结论及建议:提高村医素质并明确身份;保障村医待遇;鼓励开展研究提出吸引卫生人员到农村执业的更切实可行的建议。 
  关键词:乡村医生  待遇  执业  现状
 
The current status of village health worker practice and their remuneration:Based on survey in 18 counties of 6 provinces
ZHANG Xiao-juan, TIAN Miao-miao, ZHU Kun
Center for Health policy and Management, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
 
 Abstract:Objective:To analyze the current status of village health worker practice and their remuneration in six provinces. Methods:After 18 counties (cities/districts) from 6 provinces are selected based on their levels of economic and social development, this paper uses self-designed questionnaires to survey all village clinics under the jurisdiction of these 18 counties. Results:The average numbers of village health workers range from 6.79 to 19.05 per 10,000 rural populations and 1.36 to 3.24 per village. In some provinces, more than 20% of the village health workers are 60 years old, and the educational level of more than 50% is technical secondary school and they have village health worker practicing certificates only. The coverage ratio of medical malpractice liability insurance among village health workers in two western provinces is less than 11%. Except Jiangsu province, village health workers in the other five provinces have mainly joined the New Rural Pension Scheme (NRPS). Jiangsu province ranks the highest in subsidies for the services of public health and essential medicines per village health workers, and Fujian province ranked the lowest. Village health workers who are included in the administrative staffing management of township health centers account for less than 20%. Except Jiangsu province, more than 70% village health workers provide 24-hour service. The number of the outflow personnel is higher than the number of the inflow. Conclusions and Suggestions:The problem of village health worker aging is getting worse. Their education level, practicing quality and remuneration are low. This paper suggests the government not only improve the practicing quality and define the legal status of village health workers, but also increase the remuneration, incentives and job satisfaction of village health workers Further studies should be conducted in order to put forward a more practical advice about how to attract more health workers in rural areas. 
 keywords:Village health workers  Remuneration  Village health worker practice  Current status