【摘要】 目的从农村卫生服务管理者、组织者和提供者入手,分析其对现行乡村医生队伍走向、服务模式改革的举措及其可行性等方面的意向。为上海市乡村医生服务模式实践改革提供科学的依据。方法采用分层整群随机抽样的原则,调查并分析上海市8个郊区(县)24个乡镇72个村312名农村卫生服务组织者和提供者的意向。结果和讨论如果乡镇卫生院对乡村医生队伍进行替代,乡镇卫生院需要继续提供24小时随叫随到的服务(70.1%的认可率),而乡镇卫生院不具有24小时电话预约、随叫随到的服务能力(63.3%的认可率)。乡村医生由乡镇卫生院医务人员替代是不可行的(75.7%的认可率)。相反,应通过增加政府重视和政策保障,实行乡村卫生服务一体化管理,实行乡村医生聘用制,择优录用,竞争上岗,完善评估和考核机制等,明确乡村医生性质和地位,增加乡村医生收入,加强乡村医生培训等,保留和稳定这一队伍以适应形势不断发展的需要(98.3%的认可率)。更多还原

【Abstract】 OBJECTIVE To explore rural doctors’ development,reform and its feasibility by health care organizers and providers’ willing in Shanghai of China.METHOD By using stratified cluster and random sampling,the paper surveyed and analysis the willing of 312 health care organizers and providers in 72 villages of 24 towns from 8 districts in Shanghai.RESULTS and CONCLUSIONS If substituting rural doctors for doctors of town hospitals,the town hospitals should provide the 24 hours service and visiting a patient at home according to residents’ demand,approved by 70.1% of health care organizers and providers.However,at present,town hospitals couldn’ t assume this task,approved by 63.3% of health care organizers and providers.75.7% of health care organizers and providers thought this substitution was not feasible.On the contrary,rural doctors should be kept and stabilized by increasing the government’ s attention,putting in practice the Policy of Integrated Management Town and Village Health Organizations,training rural doctors,substituting them for doctors with higher quality with their retiring,and making them normalized.更多还原