定兴县标准化村卫生室建设现状及对策

发布时间：2018-09-05 20:25

【摘要】：由于城乡医疗卫生资源分配不均,农村无论是在医疗服务的基础设施方面,还是在医疗服务水平方面,与城市相比有很大差距。为了解决农村群众“看病难,看病贵”等问题,2009年国家颁布了新医改方案,提出健全基层医疗卫生服务体系,提高基本医疗卫生服务的可及性,每村有一所规范化村卫生室。河北省政府贯彻新医改精神,2012年加大标准化村卫生室建设力度,定兴县作为河北省医改试点推进县,规定每村建设一所标准化村卫生室。本文以定兴县标准化村卫生室为调查对象,采用实地观察、问卷调查和访谈的方法,对标准化村卫生室建设情况进行调查分析。通过对调查问卷和访谈记录整理发现,定兴县在标准化村卫生室建设和管理方面积累了一定的实践经验,如政府部门建立了良好的工作机制；乡镇干部和村干部在建设过程中发挥了重要作用；积极整合卫生资源,推进乡村卫生服务一体化管理；注重医德教育,提升标准化村卫生室的服务质量。同时也发现了标准化村卫生室在前期投入阶段、中期运行阶段、后期管理方面的一些问题,如村卫生室布局不合理、资金投入规模不足、资金投入结构不合理、一体化管理不完善等。针对存在的问题,运用公共产品理论,财政分权理论和新公共管理理论对这些问题进行分析,最后从政府视角出发,在政府筹资、政府决策和政府管理方面提出一些对策,为促进标准化村卫生室更好地发展提供一点借鉴经验。
[Abstract]:Due to the uneven distribution of medical and health resources in urban and rural areas, there is a big gap between rural areas and cities in terms of the infrastructure of medical services or the level of medical services. In order to solve the problem of "difficult to see a doctor and expensive to see a doctor" in rural areas, the government promulgated a new medical reform plan in 2009, which proposed to improve the basic medical and health service system and improve the accessibility of basic medical and health services. Each village has a standardized village health office. Hebei provincial government carried out the spirit of new medical reform, increased the construction of standardized village clinics in 2012, and Dingxing County, as a pilot county in Hebei Province, stipulated the construction of a standardized village clinic for each village. Taking the standardized village clinic in Dingxing County as the investigation object, the construction of the standardized village clinic was investigated and analyzed by the methods of field observation, questionnaire investigation and interview. Through the questionnaire and interview records, it is found that Dingxing County has accumulated some practical experience in the construction and management of standardized village clinics, such as the establishment of good working mechanism by government departments; Township cadres and village cadres played an important role in the construction process; actively integrate health resources, promote the integrated management of rural health services; pay attention to medical ethics education, improve the service quality of standardized village clinics. At the same time, we also found some problems in the management of standardized village clinics in the early stage, the middle stage of operation and the later stage of management. For example, the layout of the village clinics is unreasonable, the scale of capital input is insufficient, and the structure of capital investment is unreasonable. The integration management is not perfect and so on. Aiming at the existing problems, this paper analyzes these problems by using the theory of public goods, the theory of fiscal decentralization and the theory of new public management. Finally, from the perspective of the government, it puts forward some countermeasures in the aspects of government financing, government decision-making and government management. To promote the development of standardized village clinics to provide some reference experience.
【学位授予单位】：西南交通大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R197.62

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