山东省乡村医生养老保障问题研究

发布时间：2018-01-25 12:26

本文关键词： 乡村医生养老保障基层医疗卫生　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：乡村医生,指的是在我国村级卫生室供职的卫生工作人员,他们是我国基层卫生组织的主力,长期以来为维护农民群众的生命健康贡献着自己的力量,其作用不可替代。随着经济社会的发展和医改政策的屡次变迁,乡村医生逐渐褪去了曾经的光环,新时代带给他们的,更多的是由于待遇降低、身份尴尬、老无所养、病无所医而造成的落魄甚至贫困。在诸多风险中,老无所养是他们最为忧心的问题。多年来,虽然全国从上至下呼声甚高、广大乡医特别是老年乡医们翘首以盼,但是乡医"养老难"却迟迟得不到应有的解决。2015年3月,国务院办公厅印发了《关于进一步加强乡村医生队伍建设的实施意见》,对各级政府探索建立健全乡村医生养老机制提供了较为有力的指导。遵循着中央指导意见,一些省份或地区相继进行了政策性的探索和实践,取得了一定成效。山东是农业人口大省,乡村医生人数众多、队伍庞大。但多年来,山东省并未制定关于乡村医生养老保障方面的专门政策,特别是2014年初,在乡村医生养老保障问题久悬不决的情况下,山东省先行出台了针对老年民办教师的生活补助政策,对于一直把自身身份与民办教师等量齐观的乡村医生来说,"厚此薄彼"的政策待遇更增加了他们的不满。可以说,养老保障制度的有无和完善程度,正逐渐成为制约及影响山东省乡医队伍稳定及发展的主要原因。本文系统梳理了乡村医生的历史渊源、发展脉络,分析了他们在各个时期中发挥的现实作用,并以山东省的乡医群体作为研究对象,采取文献研究法、问卷调研法、个案访谈法等实证研究方法,对这一群体的基本状况、收入水平、养老现状、岗位归属感等情况进行了调查研究。首先对调研结果进行统计和分析,从而查找出乡村医生养老保障中存在的养老保险类型单一、养老保障水平低下、乡医满意程度过低等突出问题;然后从乡村医生自身情况、养老保险制度、政府政策、乡村卫生一体化建设等几个方面,深入分析造成乡村医生养老难题的原因;最后尝试从研究制定养老政策、建立完善养老保险制度、提高在岗收入水平、加强队伍自身建设、推动乡村卫生一体化管理等几个方面,提出较为可行的解决对策,为乡村医生解除老无所养的后顾之忧,为乡村医生队伍留住人才,进一步夯实基层医疗卫生的"网底"安全。
[Abstract]:Village doctors refer to the health workers who serve in the village health centers in our country. They are the main force of the primary health organizations in our country and have long contributed their own strength to the maintenance of the life and health of the peasants. With the development of economy and society and the changes of medical reform policy, rural doctors gradually fade the aura of the past, the new era brings them, more because of the reduced treatment, status embarrassment. Old people without care, disease without medical care caused by the loss of soul and even poverty. Among the many risks, the old without a home is their most worried problem. For many years, although the country from top to bottom voice is very high. The majority of rural doctors, especially the elderly, are looking forward to it, but the rural doctors'"pension difficulties" have not been solved as they should be. March 2015. The General Office of the State Council issued and published "opinions on the implementation of further strengthening the Construction of Rural doctors". Government at all levels of exploration to establish and improve the rural doctor pension mechanism to provide more effective guidance. In accordance with the central guidance, some provinces or regions have carried out policy exploration and practice. Shandong is a large agricultural province with a large number of rural doctors and a large contingent. However, for many years, Shandong Province has not formulated a special policy on rural doctors' old-age security. Especially in early 2014, under the condition that the problem of rural doctors' old-age security has not been decided for a long time, Shandong Province first issued the policy of living subsidy for the elderly private teachers. For the rural doctors who have been equal to the private teachers, the policy treatment of "favouring one over the other" has increased their dissatisfaction. It can be said that the pension security system has and improved. It is gradually becoming the main reason of restricting and affecting the stability and development of rural doctors in Shandong Province. This paper systematically combs the historical origin and development of rural doctors and analyzes their realistic role in each period. And take the rural medical community in Shandong Province as the research object, take the literature research method, the questionnaire investigation method, the case interview method and so on empirical research method, to this group basic condition, the income level, the pension present situation. First of all, statistics and analysis of the results of the survey, so as to find out that there is a single type of old-age insurance in rural doctors pension security, the level of old-age security is low. Prominent problems such as the low degree of satisfaction of rural doctors; Then from the rural doctors themselves, pension insurance system, government policies, rural health integration construction and other aspects, in-depth analysis of the causes of rural doctors pension problems; Finally, the author tries to establish the pension policy, establish and improve the pension insurance system, improve the income level in the post, strengthen the team self-construction, promote the integrated management of rural health, and so on. Some feasible solutions were put forward to relieve the worries of the old doctors, to retain the talents and to further strengthen the "net" safety of the primary medical and health care.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1

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