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通过对 5年来 2 0 5篇相关文献的归纳论证 ,显示随着我国宏观经济体制改革的进程 ,计划经济时代的农村三级卫生网固有特征逐渐消失 ,基本上为下列状况所替代 :(1)协调变成了围绕各自经济利益的无序竞争 ;(2 )寻求更多一点的经济收益成为县乡村三级卫生组织的行为原动力 ,替代了社会效益和经济利益一致的“共同目标” ;(3)医疗、预防、保健三大功能定位发生混乱 ,“重医轻防、重有偿轻无偿、重收益多轻收益少”状况成为县乡村三级卫生组织的普遍现实 ;(4 )预防保健职能难以切实落实到位或流于形式成为农村地区卫生事业发展的焦点问题。这些状况在乡镇卫生院表现得尤为突出。
According to the inductive argumentation of the 20-year related literature over the past five years, it shows that with the progress of China’s macroeconomic system reform, the inherent characteristics of the rural three-tier health network in the era of planned economy have gradually disappeared and basically replaced by the following conditions: (1) Coordination has become a disorderly competition around their respective economic interests; (2) The search for more economic benefits has become the primary motive force for the county and rural three-tiered health organizations, replacing the “common goal” of social and economic benefits; (3 ) The three functions of medical care, prevention, and health care are chaotic. The situation of “giving more attention to medicine, paying more for compensation, paying more for compensation, and making more profit, and less income” has become a common reality in the county’s rural and tertiary health organizations; (4) The function of preventive health care is difficult. Putting it in place or being in a form has become the focus of the development of health in rural areas. These conditions are particularly prominent in township health centers.