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采用现况调查、意向调查等方法,旨在明确上海市乡村医生队伍、服务模式和服务内容能否满足新形势的需要;优化上述三方面所需的策略选择及支持系统,为上海市乡村医生服务的进一步改革提供科学的依据。围绕研究目的,调研上海市宝山、嘉定、闵行、松江、青浦、南汇、奉贤、崇明8个郊区(县)24个乡镇72个样本村。项目的主要研究结果:(1)村医存在人力数量相对不足,老龄化,职称、学历等素质偏低和收入偏低等问题;(2)村医服务效率偏低,服务时间仅占8小时的50.0%左右,存在着严重“重医轻防”现象;(3)每天每村医上门服务0.6次,上门服务方式保持良好,但上门服务的可及性有待提高;(4)村医服务基本满足农村居民需求,农村居民满意程度达到了98.3%;(5)实行乡村一体化管理,对村医实施培训,随着较低素质村医不断退休,使之正规化是比较理想的模式(98.3%被调查者认可);(6)随着初中及其以下学历者的退休,不断补充正规医学教育和培训者实现替代需要19年,每乡镇卫生院需承担年出诊次数为3595次;为提高村医收入和保障水平,需在现行村医人员经费基础上,增加投入7700.2万元。
The current situation investigation and intention investigation are used to clarify whether the needs of the new situation can be met by the team of rural doctors in Shanghai, service mode and service content; to optimize the strategy selection and support system required by the above three aspects, Provide further scientific basis for the further reform of services. Around the research purpose, we investigated 72 sample villages in 24 towns and villages in 8 suburbs (counties) of Shanghai Baoshan, Jiading, Minhang, Songjiang, Qingpu, Nanhui, Fengxian and Chongming. The main findings of the project are as follows: (1) There is a relatively insufficient number of manpower in village doctors, and problems such as low quality and low qualifications such as aging, professional titles and qualifications; (2) the efficiency of village doctors is low and the service time only takes up to 8 hours (3) every day, every village medical services 0.6 times, home services to maintain a good mode of service, but accessibility needs to be improved; (4) the village Medical services basically meet the needs of rural residents, and the satisfaction of rural residents reached 98.3%. (5) Integrated rural management, training of village doctors, and regularization of village doctors with lower quality are more ideal (98.3% respondents); (6) With the retirement of junior high school education and below, it is 19 years to continuously replace formal medical education and trainees to achieve substitution, and 3595 visits per township hospitals In order to increase the income and level of village doctors, it is necessary to increase the input of 77.2 million yuan on the basis of the current funding of village doctors.