新医改下山区乡村医生的生存与发展探究——以四川省古蔺县为例

Studying on the Survival and Development of the Rural Doctors in Mountain Areas Under the New Medical Reform Sampled with Gulin County

目的:通过对古蔺县乡村医生的收入情况及其所在村卫生室的运营状况等进行调查,了解新医改背景下古蔺县乡村医生的现状,并对其可持续发展进行探究。方法:问卷调查317名乡村医生的收入情况及所在村卫生室运营情况;访谈12名乡村医生。结果:新医改实行药品零差价销售,减轻了老百姓的用药负担,但对之前较高比例靠药品加成为收入的乡村医生而言,收入有所降低;新医改要求乡村医生集中行医,降低了山区群众医疗获得的可及性。结论:乡村医生在类似古蔺县的山区地区存在十分必要;在新医改背景下,加大对乡村医生的支持力度,采取灵活措施保障山区乡村医生的生存和发展,为山区群众提供更好的健康服务。

Objective To study the status of the rural doctors in Gulin County under the new medical reform and its sustainable development. Methods The status of income of 317 cases of rural doctors and operation of village clinics was surveyed with questionnaire. And 12 cases of rural doctors were interviewed. Results The new medical reform has reduced the patients＇ burden of medication, and also decreased the rural doctors＇ income. The policy of centralized medical services has influenced the accessibility of medical services. Conclusion Rural doctors play a significant role in medical services in mountain areas. It is suggested to intensify the support and implement flexible measures for the survival and development of the rural doctors.