我国乡村医生执业风险分担机制的构建研究

Construction of Risk-sharing Mechanism for Rural Doctors' Practice in China

目的探讨建立乡村医生执业风险分担机制的必要性,并就乡村医生执业风险分担机制的具体制度设计提出建议。方法采用整群抽样方法,选取北京市昌平区7个乡镇的133名乡村医生进行问卷调查。结果 75.2%(100/133)的乡村医生认为目前面临的执业风险非常大或比较大,90.2%(120/133)的乡村医生都非常担心或比较担心发生医疗纠纷。96.2%(128/133)的乡村医生都认为应该建立执业风险分担机制,并认为出资主体应多元化,且68.4%(91/133)的乡村医生自身的出资意愿较高。结论我国亟待建立乡村医生执业风险分担机制。应结合乡村卫生服务一体化的政策环境,在乡镇卫生院的主导之下,秉承"全面覆盖、分类对待"的原则,探索灵活有效的、切实可行的风险分担方式,同时完善农村医疗纠纷解决机制,保障农村医疗卫生事业的健康发展。

Objective To explore the necessity of establishing risk - sharing mechanism for rural doctors＇ practice, and put forth the suggestion on concrete system design. Methods The cluster sampling method was used to choose 133 rural doc- tors from 7 townships in Chang-ping District of Beijing. And a questionnaire survey was conducted among them. Results There were 75.2% （ 100/133 ） of the subjects who held that the risk of medical practice was bigger, and 90. 2% （ 120/133 ） of them who were anxious about encountering medical disputes. Some 96. 2% （128/133） held that a risk -sharing mechanism for rural doctors＇ practice should be established, the main found -providers should be diversified, and the motivation to provide fund was higher in 68.4% （91/133） of them. Conclusion Establishing a risk - sharing mechanism in rural doctors＇ practicing is ur- gent. In combination with the integration of policy environment in rural health services, under the guidance of the township hospitals, and adhering to the principle of ＂ full coverage, classified treatment＂, it is necessary to explore a flexible, effective, and feasible risk - sharing, and improve the mechanism to settle rural medical dispute so as to ensure healthy development of rural health cause.