【作者】 宋修珍；

【导师】 郑建中；

【作者基本信息】 山西医科大学 ， 社会医学与卫生事业管理， 2003， 硕士

【摘要】 本研究在分析样本地区(运城市)农村卫生工作现状的基础上，提出农村卫生资源合理配置的模式和配置量，旨在建立功能完善，结构合理，规模适宜的县、乡、村三级医疗卫生保健网，为农村居民提供能满足其基本需求的卫生服务。 样本地区辖13个县(市、区)共有卫生机构6084个，床位12026张，各级各类卫生人员共21280人，卫生机构中县医院14所，乡镇卫生院201所，村卫生室3253所，个体诊所2469个。卫生事业经费来源主要以县级政府的投入为主。本次共调查14所县医院，25所乡镇卫生院，85所村卫生室，结果显示，农村卫生资源配置与农村居民的需求不相匹配，卫生资源的配置效率不高。农村卫生人力资源素质低，高学历和高职称特别是较低级别医疗机构中高学历高职称人员所占比例偏小。床位资源高于全国平均水平，但利用率较低，县级医院的床位利用率为55.36％，卫生院仅为34.30％。从卫生资源分布的公平性看，样本地区卫生人力资源和床位资源在各地间配置的公平性较好，且人力资源的配置公平性要优于床位资源。 针对这些情况，建议样本地区农村卫生工作重点应健全县、乡、村三级卫生保健网，合理分配卫生资源。为此，应充分发挥市场和政府这两种手段在调整卫生资源中的作用。政府应根据社会经济发展状况和人们对医疗卫生保健的需求控制农村卫生资源的总量。对卫生人力的增量严格控制质量关，引进素质高、能力强的卫技人员。在培养适合农村卫生工作的人才方面，可探索一些符合实际、操作性强的模式，如联合培养，带薪脱产培训，山1穿医利‘口悦月六招犯耳只申侧降币眨d二月瞬亡之内卜习七乍仑岁仁举办讲座等丰富实用的形式，确保一批留得住、用得上的农村卫生队伍。建立适应社会经济水平和人群健康需求的价格体系，同时建立完善的价格监管机制，有效控制卫生服务价格市场。积极推广新型“合作医疗制度”，逐步完善农村社会保障体系。对无能力获得卫生服务供给的人群，可考虑实行特困救助，保护弱势群体，提高卫生资源利用的可及性和可得性，促进社会公平。更多还原

【Abstract】 In order to provide information for the regional health planning (RHP) in YunCheng city, this study was trying to know the problem of the health and status of supplying and demand of health resources.The investigation data indicated there were 6084 medical institutions in 13 counties and districts, and they had 12026 hospital beds and employed 21,280 all levels and classes of health staffs. There were 201 township hospitals and 3,253 village cliniques, 2,469 private clinics. In Yuncheng city, health service cost mainly comes from county government input. There were 14 county hospitals, 25 township hospitals and 85 village clinics were investigated. The result shows that allocation of medical resource was not reasonable. The diathesis of medical manpower was low. People has great potential demand in medical care. Medical care in different levels are unreasonable. Total health resources of hospital beds are superfluously, but the nurses which are insufficiency. Extent for demand of health resources are different in different level of the medical institutions .The resources lack in primary medical department while superfluoused in high medical department.Based on these study, the author think that how to allocated medical resource reasonbaly is the most important task. The effective measures for improving medical service in rural area are to optimize medical resource. In order to make full and rational use of limited health resources, the government should practice administrative macro-control and take policy-guided measures on the basis of ensuring the micro-regulation function of market economy.更多还原