Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the ta...Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.展开更多
目的在健康管理视角下,从供给层面界定村卫生室健康服务项目,为相关研究及政策的制定提供依据,以改进、完善村卫生室健康服务项目内容。方法于2011年8月10—25日,在山东省随机抽取1个发达地区（市）,采用分层随机抽样方法,根据经济文化...目的在健康管理视角下,从供给层面界定村卫生室健康服务项目,为相关研究及政策的制定提供依据,以改进、完善村卫生室健康服务项目内容。方法于2011年8月10—25日,在山东省随机抽取1个发达地区（市）,采用分层随机抽样方法,根据经济文化发展状况把所辖县分为发达、中等、欠发达三层,每层随机抽取一个县,共抽取3个县;各县按同样的方法把所辖乡镇分为三层,每层随机抽取一个乡镇,共抽取9个乡镇;各乡镇再按同样的方法把所辖村分为三层,每层随机抽取一个村,共抽取27个村。对27个村的村卫生室进行现场调研;根据研究目的,在抽取的9个乡镇的卫生院中,选取3位乡镇卫生院负责人,在抽取的27所村卫生室中,选取6位村卫生室负责人和17位医务人员,共计26人,进行深入访谈;采用Delphi法给出专家认为村卫生室各供给项目开展的重要性程度。通过Epi Data 3.0软件建立数据库并录入数据,利用SPSS 17.0统计软件、采用流行病学统计方法进行数据分析。结果对于村卫生室实际提供项目及其提供程度,有3项服务项目供给程度达到100.0%,13项服务项目供给程度在50.0%及以上,9项服务项目供给程度在8.0%~40.0%。结论村卫生室健康服务项目的供给达到了一定程度,但整体服务能力仍然偏低。建议村卫生室引入健康管理理念,完善、优化村级健康服务项目;加强宣传,深入、连续、全面地开展健康服务;进一步完善供给功能,优化卫生资源配置,提高资源利用率。展开更多
基金supported by the National Natural Science Foundation of China(No.71273097)
文摘Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.
文摘目的在健康管理视角下,从供给层面界定村卫生室健康服务项目,为相关研究及政策的制定提供依据,以改进、完善村卫生室健康服务项目内容。方法于2011年8月10—25日,在山东省随机抽取1个发达地区（市）,采用分层随机抽样方法,根据经济文化发展状况把所辖县分为发达、中等、欠发达三层,每层随机抽取一个县,共抽取3个县;各县按同样的方法把所辖乡镇分为三层,每层随机抽取一个乡镇,共抽取9个乡镇;各乡镇再按同样的方法把所辖村分为三层,每层随机抽取一个村,共抽取27个村。对27个村的村卫生室进行现场调研;根据研究目的,在抽取的9个乡镇的卫生院中,选取3位乡镇卫生院负责人,在抽取的27所村卫生室中,选取6位村卫生室负责人和17位医务人员,共计26人,进行深入访谈;采用Delphi法给出专家认为村卫生室各供给项目开展的重要性程度。通过Epi Data 3.0软件建立数据库并录入数据,利用SPSS 17.0统计软件、采用流行病学统计方法进行数据分析。结果对于村卫生室实际提供项目及其提供程度,有3项服务项目供给程度达到100.0%,13项服务项目供给程度在50.0%及以上,9项服务项目供给程度在8.0%~40.0%。结论村卫生室健康服务项目的供给达到了一定程度,但整体服务能力仍然偏低。建议村卫生室引入健康管理理念,完善、优化村级健康服务项目;加强宣传,深入、连续、全面地开展健康服务;进一步完善供给功能,优化卫生资源配置,提高资源利用率。
