我国“乡聘村用”政策典型地区实践经验与启示

Practices and Enlightenment of the“Employed by Townships and Work in the villages”Policy in Typical Areas of China

目的:分析我国"乡聘村用"政策进展和典型地区实践经验,分析推进"乡聘村用"政策的问题与挑战,为推进乡村医生队伍建设提供政策建议。方法:利用我国卫生健康统计年鉴相关数据进行定量分析;收集我国典型地区政策、报告等资料,进行案例分析。结果:"乡聘村用"在我国具有一定的政策基础,在全国范围内已经具有一定实践规模。从人员资质、人事管理和养老保障及资金来源方式等角度看,在典型地区的实践对推进"乡聘村用"政策的挑战是增加财政支出、乡村医生队伍老龄化和县乡管理能力不足。结论与建议:典型地区经验表明"乡聘村用"政策是转变乡村医生身份、解决乡村医生养老等社会保障问题的有效途径。建议各地借鉴典型经验积极推进"乡聘村用"政策,加大地方财政支持力度;加强县级和乡镇卫生院管理能力;同时,稳步推进政策,避免各类乡村医生之间产生矛盾。

Objective:To analyze the policy progress and practices of personnel management of rural doctors in China,and summarize challenges in employing rural doctors for township hospitals in rural areas in China,and propose policy recommendations for rural health human resources construction.Methods:The related data of Health Statistic Yearbook was explored by quantitative analysis.Case studies were used based on the policies and reports collected from typical areas.Results:The"employed by townships and work in villages"policy has practice basis in China.There were mainly three types of policy practices in terms of doctors’qualification,personnel management,social insurance and financial support in typical areas.The challenges for the policy included increasing the fiscal expenditure,ageing problem in village doctors,and the low management capacity in towns.Conclusion:Policy practices in typical areas demonstrated that township hospitals employing and managing the rural doctors was an effective way to provide rural doctors with an identity of health human resource and solve their pension security problem.It was recommended that experiences of typical areas should be popularized in other parts in China,financial support should be strengthened,and township hospitals’management capacity should be elevated.At the same time,the policy should be steadily implemented,so as to avoid the conflicts among different village doctors.