山东省德州市某县乡镇卫生院中医药服务开展现状的质性研究

Qualitative Study on the Present Situation of TCM Service Development in Township Health Centers of a County in Dezhou of Shandong Province

目的:了解山东省德州市某县乡镇卫生院中医药服务的开展现状,为完善基层中医药发展提供对策和建议。方法:对德州市某县14家乡镇卫生院的院长、分管中医的副院长及16位中医医生进行半结构访谈,采用Colaizzi现象学对资料进行分析。结果:14家卫生院共29名中医执业医师开展中医药服务,平均每家2人,掌握适宜技术数量≤6类。提供服务主要包括针刺类、灸类、拔罐推拿类、敷熨熏浴类项目以及30%左右的中草药处方,实施过程中存在高层次中医药人才短缺、适宜技术掌握程度不足、中医药事业经费投入有限,群众认知度不高等问题。结论:乡镇卫生院中医药服务开展仍存在诸多困难,建议应逐步完善中医药财政与医保支持,落实人才保障政策,通过加强人员培训、技术推广、中医药文化宣传,创新发展基层中医药事业。

Objective:To understand the current status of TCM services in township health centers of a county in Dezhou of Shandong province,so as to provide countermeasures and suggestions for improving the development of TCM at the grassroots level.Methods:Semi-structured interviews were conducted with the directors of 14 township hospitals in Dezhou,the vice-directors in charge of Chinese medicine,and 16 Chinese medicine doctors selected by purposive sampling,and the data were analyzed using Colaizzi phenomenology.Results:A total of 29 TCM practitioners in 14 health centers provided TCM services,with an average of 2 practitioners per family,and the number of appropriate techniques mastered was less than 6.The services mainly included acupuncture,moxibustion,cupping and massage,application,ironing and fumigating bath,and about 30%of Chinese herbal medicine prescriptions.In the process of implementation,there were problems such as shortage of high-level Chinese medicine talents,inadequate mastery of appropriate technologies,limited investment in Chinese medicine and low public recognition.Conclusion:In township health centers,there exist many difficulties.It’s suggested that the government should gradually improve fiscal of traditional Chinese medicine and health care support,carry out the talented person security policy,develop traditional Chinese medicine at the grassroots level in an innovative way by strengthening personnel training,technology promotion and traditional Chinese medicine culture publicity.