东部地区乡村医生补偿和养老问题研究——基于常熟市的现场调研

Study on Remuneration and Pension of Village Doctors in the Eastern Area——Based on a Survey in Changshu

目的总结分析常熟市乡村医生补偿和养老的主要做法和现状。方法通过自行设计的调查表调查109名乡村医生,收集相关定量资料;并通过个人深入访谈和焦点组访谈收集定性资料。结果乡医日均工作时间超过9 h,公共卫生服务量约占总工作量的50.0%;2009年医改以来,84.2%的乡医认为工作量有所增加,增加幅度中位数为20.0%,原因主要为公共卫生服务增加;乡医目前月收入中位数为3 000元,与医改之前相比,59.3%乡医收入增加,主要原因为政府补助增加;乡医期望收入中位数为5 000元,期望收入与目前收入之差的中位数为1 950元;有超过一半的乡医对收入(68.4%)、养老保险(63.5%)不满意和非常不满意;27.9%的乡医有离职意愿。结论常熟市建立了较为完善的乡医补偿和养老机制,但乡医岗位依然缺乏吸引力,新人进入困难。建议加快乡医定点委托培养的速度;制定适宜政策引导应届毕业生进入乡村医生队伍;要统筹做好镇村人才队伍建设。

OBJECTIVE To analyze the policy and the present situation of remuneration and endowment for village doctors. METHODS 109 village doctors were surveyed to get quantitative data and qualitative data was collected by individual and group interview. RESULTS Village doctors work more than 9 hours a day on average and the workload of public health service is almost 50.0%. After health reform in 2009, most village doctor suggested that their workload increased about 20.0% and the reason was much more public health task. The median of income was 3 000 yuan. After 2009, 59.8% village doctors thought their income increased and the main reason was much more allowance from government. The median of expected income was 5 000 yuan which is 1 950 yuan more than the actual income. More than half village doctors ware not satisfied with income and endowment insurance. 29.7% village doctors have the willingness to resign. CONCLUSION The mechanism of remuneration and endowment for village doctors was built but there was still not enough attraction for new village doctors. It is suggested to accelerate the students enrolled by contract for village doctors; make appropriate policy to attract graduates to be village doctors and coordinate the construction of human resources for town and village.