医改背景下乡村医生队伍建设的成效、困境及出路

Effects,Predicaments and Solutions of the Team of Rural Doctors Under the Background of Health Care Reform

乡村医生是农村居民健康的守护者,乡村医生队伍的状况直接关系着我国农村卫生事业的发展。比较医改前后的数据发现,2008-2013年乡村医生数量增长22.49%,其中执业(助理)医师数量增长143.56%。乡村医生队伍面临的困境是收入与付出不相符、执业化进程缓慢、执业风险增大、人才队伍补充相对不足、养老保障机制不健全、继续教育流于形式等。建议加大政府投入并提高资金使用效率,调整执业资格考试要求,建立医疗风险互助机制,构建多种人才补充渠道,实施不同的养老保险政策,开展基于乡村医生特点的继续教育。

Rural doctors are the guardians of rural residents＇ health. The development of rural health services is directly related to the availa- bility of rural doctors. By comparing the data before and after medical reform, we found that the number of rural doctors increased by 22.49% and the number of medical practitioners or assistant medical practitioners increased by 143.56% from 2008 to 2013. The six predicaments what the team of rural doctors faced were mismatching of income and labor, slow professional qualification conversion, medical risk increasing, rural doctors being temporary shortage, unsound mechanism of old-age security, continuing education becoming a mere formality. The paper put forward some proposals such as increasing and optimizing governments＇ investment, adjusting the medical licensing examination requirements, implementing a mechanism of medical risk sharing, introducing medical talents in multi-channel, carrying out different old-age security and conducting the continuing education based on the actual situation of rural doctors.