农村社区卫生服务的实践与思考

Practice in and reflection on rural community health care in our district

该区将城市社区卫生服务与农村初级卫生保健“合二为一”,在位于城郊结合部的6个乡镇开展了农村社区卫生服务的试点工作。主要做法:①以社区卫生服务联系系统内外、区域内外、行业内外,合理配置卫生资源,将卫生服务的重心移向社区;②以预防为主,走防治结合的道路,开展集医疗、预防、保健、康复、健康教育、计划生育技术指导“六位一体”的卫生服务;③乡镇卫生院由过去的以疾病为中心转向以健康为中心,由原来发展小专科走上发展社区卫生服务的道路;④将合作医疗保险与健康保健合同“合二为一”。主要体会:①当前开展农村社区卫生服务,顺应了第二次卫生革命的潮流;②发展农村社区卫生服务,亟需政府的关心、社会的支持和群众的拥护;③发展农村社区卫生服务,需要培养一批掌握适宜技术的全科医生。

Combining urban community health care with primary health care in rural areas, our district started experimental work in rural community health care in 6 towns on the outskirts of Nanjing. The work includes the following aspects. ①Community health care was used to bridge the region with other regions and the health trade with other trades, health resources were rationally allocated and the focus of health care was shifted to the community. ②The path of prevention combined with treatment was taken, with priority given to prevention. Health services integrating medical treatment, prevention, healthcare, convalescence, health education and technical guidance in family planning were conducted. ③Township health stations shifted their focus from disease to health and took the path of developing community health care in place of that of developing minor specialties. ④Cooperative medical insurance contracts and health insurance contracts were combined into one. Our experience has led to the following conclusions. ①Conduction of rural community health care at present goes along with the trend of the second health revolution. ②Development of rural community health care is in dire need of government solicitude and social support. ③Quite a number of general medical practitioners with the mastery of appropriate techniques need to be cultivated for the development of rural community health care.