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农村居民就医行为的主观性和国家政策层面的设计目的是不完全协调统一的。因此,农村居民自身的就医行为对农村基层医疗服务体系的发展和完善有积极或消极的影响。山西省洪洞县东张村是洪洞县首批社会主义新农村推进村,其发展在洪洞县具有典型的代表性。文章运用社会科学研究方法“质性研究”中的深度访谈,对目标村30名农民、7名基层卫生服务提供者和部分卫生管理人员进行访谈。调查发现,影响该村居民就医行为的主要因素不是医疗服务室的基础设施建设及所处的地理位置,而是医疗服务提供者的医疗技术水平。尽管政府不断推进农村医疗改革,但基层医疗服务提供者的医疗水平并没有大幅提升,农村缺乏优秀的医疗人才已成为影响农村居民就医行为的主要因素。文章所做的研究旨在为进一步推进农村医疗改革提供一定参考。
The subjectivity of rural residents’ medical treatment and the design purpose at the national policy level are not completely harmonized. Therefore, the rural residents’ own medical treatment has a positive or negative impact on the development and improvement of the rural grass-roots medical service system. Dongxiang Village, Hongdong County, Shanxi Province, is the first village to promote new socialist countryside in Hongdong County. Its development is typical in Hongdong County. The article interviewed 30 peasants, 7 grassroots health service providers and some health managers in the target village using the in-depth interviews in the social science research method and the “qualitative research”. The survey found that the main factors that affect the medical treatment of residents in the village are not the medical facilities’ infrastructure construction and geographical location but the medical technology of medical service providers. Although the government keeps pushing forward rural medical reform, the medical care of primary health care providers has not risen sharply. The lack of excellent medical personnel in rural areas has become a major factor affecting the rural residents’ medical treatment. The research done in this article aims to provide some reference for further promoting rural medical reform.