目的结合广西壮族自治区无证行医查处情况,分析无证行医屡禁不止的原因,探讨建立打击无证行医长效监管机制。方法采用广西壮族自治区2012-2014年无证行医查处信息统计资料进行无证行医的构成、处罚对象、处罚次数等的分析。结果 3年共查处非法行医案件2 810件,其中无证行医案件1 270件,占45.20%,无证行医案件数与其他案件数构成比差异无统计学意义(χ~2=3.29,P=0.21);无证行医处罚对象85.04%为个人无证行医,14.96%为非医疗机构,差异有统计学意义(χ~2=38.04,P=0.01);平均每个无证行医案件罚款3 801.73元,没收违法所得890.63元;无证行医强制执行比例逐年下降,2012年最高为9.18%,2014年最低为2.22%,3年间强制执行案件数差异有统计学意义(χ~2=25.58,P=0.01);无证行医案件中有1 094件为首次处罚,176件被卫生行政部门做出过两次以上(含两次)的行政处罚,3年间无证行医处罚次数差异无统计学意义(χ~2=2.85,P=0.24);无证行医场所为自有住房的669件,所占比例最高为52.68%,流动场所53件,所占比例最低为4.17%,差异有统计学意义(χ~2=58.16,P=0.01);未取得医疗机构执业许可证开展诊疗活动占无证行医违法行为类型的83.62%,未取得医师资格从事医疗活动占12.60%,未取得乡村医生从业证书从事乡村医疗活动占3.78%,3年间案件的违法行为差异无统计学意义(χ~2=2.46,P=0.66)。结论 2012-2014年广西无证行医现象仍然突出,个人无证开展诊疗活动为主要表现形式,未取得医疗机构执业许可证开展诊疗活动是主要违法行为类型,无证行医处罚力度偏低,再次无证行医等现象应引起足够重视,建议进一步加大无证行医案件查处和舆论宣传力度,加强基本医疗服务保障体系建设,修订相关卫生法律法规,建立政府牵头,部门配合的工作机制,以遏制无证行医违法行为。 Objective To investigate the reasons for the unlicensed medical practice in Guangxi Zhuang Autonomous Region, analyze the reasons for the continuous ban on unlicensed medical practice and discuss the establishment of a regulatory mechanism to combat the long-term effects of unlicensed medical practice. Methods The data of undocumented practice, the object of punishments and the number of punishments were analyzed using statistical data of undocumented patrols from 2012 to 2014 in Guangxi Zhuang Autonomous Region. Results A total of 2 810 illegal medical practice cases were investigated over the past three years, including 1 270 cases of unlicensed medical practice, accounting for 45.20%. There was no significant difference in the number of cases of unlicensed medical practice and other cases (χ ~ 2 = 3.29, P = 0.21). 85.04% of the subjects without a license for medical treatment were individuals without a license and 14.96% were non-medical institutions with a significant difference (χ ~ 2 = 38.04, P = 0.01); on average, a fine of 3 801.73 Yuan, confiscated illegal income of 890.63 yuan; the proportion of unlicensed medical practitioners decreased year by year, the highest in 2012 was 9.18%, the lowest in 2014 was 2.22%, 3 years the number of enforced cases was statistically significant (χ ~ 2 = 25.58, P = 0.01). There were 1 094 cases of unlicensed medical practice for the first time and 176 cases of administrative penalty for twice or more (including twice) by the health administrative department. There was no significant difference in the number of unlicensed medical practice in 3 years (χ ~ 2 = 2.85, P = 0.24). There were 669 unlicensed medical establishments for their own houses, with the highest proportion being 52.68% and 53 places with the lowest proportion being 4.17%, the difference was statistically significant (χ ~ 2 = 58.16, P = 0.01). 83.62% of the types of illegal medical activities without medical license were not obtained Medical qualification of physician engaged in medical activities accounted for 12.60%, medical certificate of rural doctors did not get rural medical activities accounted for 3.78%, 3 years, the case of illegal behavior was no significant difference (χ ~ 2 = 2.46, P = 0.66). Conclusion The phenomenon of practicing without a license is still outstanding in Guangxi from 2012 to 2014. Individuals without a license are the main forms of medical treatment and treatment activities. It is the main type of illegal activity to conduct medical treatment without a license from a medical institution. The intensity of unlicensed medical practice is low. It is suggested that more efforts should be made to investigate and prosecute undocumented medical cases and to publicize propaganda, strengthen the construction of basic medical service security system, amend relevant health laws and regulations, and establish a government-led and departmental working mechanism to curb the absence of Evidence of illegal practice.