北京市郊区农村基层医疗卫生服务能力现状及问题分析

Analysis on the Current Situation and Problems of Rural Primary Medical and Health Service Ability in Suburban Areas of Beijing

目的分析北京市郊区村巡诊和村卫生室建设现状,为完善农村基层医疗卫生服务体系建设提供参考。方法对北京市郊7个区中119个行政村进行实地观察,并对652名相关研究对象进行半结构化访谈,包括对巡诊和卫生室的满意度、基层医疗机构的服务质量等。结果村巡诊服务效率不高,不能满足居民实际医疗服务需求;村卫生室医疗人员短缺,基本药物配备不全,报销途径不畅通,村民就医行为更倾向于选择乡镇卫生院和县医院。结论为更好落实卫生领域重要民生项目,切实提升农村居民就医体验,应进一步落实和丰富村巡诊内容,加强基层全科医生培养力度,提升卫生费用投资的针对性和有效性,把村卫生健康服务情况纳入村干部工作考核指标,优化基本药物目录,扩大新农合定点报销覆盖范围等。

Objective To analyze the current situation of village visits and village clinics in suburban areas of Beijing,and provide reference for improving the construction of rural primary medical and health service system.Methods Field observations were conducted in 119 administrative villages in 7 districts in the suburbs of Beijing,and 652 participants were semi-structured interviewed,including satisfaction with visits and clinics,and service quality of primary medical institutions.Results The village visit service was not efficient and could not meet the actual medical service needs of residents;the village clinic had a shortage of medical staff,incomplete basic medicines,and poor reimbursement.Villagers preferred to go directly to township hospitals and county hospitals.Conclusion In order to better implement important livelihood projects in the health field and effectively improve the medical experience of rural residents,it is necessary to further implement and enrich the content of village visits,strengthen the training of basic-level general practitioners,improve the pertinence and effectiveness of health expenditure investment,include village health services in the assessment targets for village officials,improve the list of basic medicine and the coverage of designated reimbursement for the new rural cooperative medical care system.