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文章依据调查资料,用数据论证了乡镇卫生院在承担HFA规划的实施任务时,必将面临的三种矛盾及相应出路:一在补偿问题纠缠下,从以医养防发展至重医轻防,补偿既未得缓解,资源却又利用不足。出路在于乡镇卫生院必须遵循适宜规模和适宜技术原则,以相对过剩的医疗服务资源弥补防保资源的不足。二为乡村卫生组织之间以村卫生室占主导地位的围绕经济利益的竞争,使乡镇卫生院在完成扶持村卫生室达HFA规划要求时,自身利益受损。出路在于有效协调乡村卫生组织,将彼此的利益统一到共同的目标之中。三为预防增进了人群健康,缩小乡镇卫生院医疗市场,医疗市场却又是卫生院生存之源。解决这一矛盾有赖于区域内合理规划,人财、物资源,在保证防保工作落实的前提下,调节医疗服务职能。
Based on the survey data, the paper demonstrated the three contradictions and corresponding exits that the township health center will face when undertaking the implementation tasks of the HFA plan: One, entangled in the compensation issue, from the development of medical protection to the light prevention of medical treatment. Compensation has not been eased but resources are underutilized. The way out is that the township health centers must follow the appropriate scale and appropriate technical principles, and make up for the lack of preventive resources with relatively surplus medical service resources. Secondly, the competition between rural health organizations and the economic interests that dominates the village clinics has caused the township hospitals to lose their own interests when they complete the support for the HFA planning requirements of the village clinics. The way out is to effectively coordinate the rural health organizations and harmonize the interests of each other into common goals. In order to prevent the increase of population health and reduce the medical market of township hospitals, the medical market is the source of survival of health centers. Resolving this contradiction depends on reasonable planning, human resources, and resources in the region, and on the premise of guaranteeing the implementation of prevention and protection work, regulating medical service functions.