本市乡村医生队伍和村卫生室建设存在问题与政策建议(1)
摘 要 本市乡村医生队伍综合保障逐步完善、结构不断优化，村卫生室建设网底健全、运行公益;但同时存在老一代乡村医生收入较低、青黄不接和新一代乡村医生职业发展空间受限，以及村卫生室布局需优化、一体化管理需深化和功能定位需明确化的问题。乡村医生队伍建设方面，建议加强新一代乡村医生培养并拓展其职业发展空间，提高老一代乡村医生的综合保障;村卫生室建设方面，建议优化布局同时提升服务效能，并引入内部市场机制激发活力。
关键词 乡村医生 村卫生室 存在问题 政策建议
中图分类号：R192.3 文献标识码：A 文章编号：1006-1533(2015)04-0016-04
The problems existing in the construction of the rural doctor team and the
, http://www.100md.com
village health stations in Shanghai and policy suggestion
WAN Heping1， JIN Peiwu2
(1.Shanghai Community Health Service Management Center， Shanghai 200040， China; 2.Shanghai Municipal Commission of Health and Family Planning， Shanghai 200125， China)
ABSTRACT The comprehensive security of the rural doctors in Shanghai has been gradually improved and their structure has been constantly optimized. The network of the village health stations at the end is perfect and its operation shows the public welfare. But there exist the problems that the income of the older generation of rural doctors is low， the rank lacks the successors， the career development space for the new generation of rural doctors is limited， and the layout of the village health stations needs optimization， the integration management needs deepening and the service function requires definition at the same time. In the aspect of the rank construction of the rural doctors， it is suggested to strengthen the new rural doctors’ training， expand their career development space and improve the comprehensive security of the older generation of rural doctors. In the aspect of the construction of the village health stations， it is suggested to optimize its layout， to improve the service efficiency at the same time and introduce the internal market mechanism to stimulate the vitality.
, 百拇医药
KEY WORDS rural doctor; village health station; existing problem; policy suggestion
乡村医生是农村最基层的卫生服务人员，村卫生室作为农村三级医疗卫生网的网底，长期以来在维护本市郊区农民健康方面发挥着难以替代的作用。
基本概况
乡村医生
本市乡村医生是指在村卫生室执业的医生，包括老一代乡村医生(简称“老乡医”)和新一代乡村社区医生(特指本市郊区2006年起定向免费培养的具有临床医学大专及以上学历的新一代执业(助理)医师，简称“新乡医”)。截止2014年5月，本市共有老一代和新一代乡村医生共3 492名。
乡村医生性别、年龄构成情况
, http://www.100md.com
男性1 351名，占38.69%，女性2 141名，占61.31%;51～60岁为1 362名，人数最多，占比39.00%，其次是60岁以上697名，占比19.96%，呈现“女多男少、年龄老化”的现况，具体见表1。
乡村医生学历、执业资格构成情况
高中以下人数最多，为1 557名，占44.59%，其次是中专1 201，占34.39%;按执业资格，执业助理医师人数最多，为2 026名，占58.02%，其次是上海市注册乡医875名，占25.06%，总体上素质不高，具体见表2。
乡村医生收入保障方面
新乡医按政策符合条件后纳入社区卫生服务中心编制，享受社区卫生服务中心医务人员同工同酬待遇。老乡医收入保障逐步纳入区县、乡镇整体卫生经费预算，趋向收支两条线管理。如松江区、金山区对乡村医生保障实施区级统筹，区财政托底;其他区县以乡镇为预算主体进行托底保障，呈逐年增长态势。2013年，本市老乡医年收入平均为4.33万元。, 百拇医药(万和平 金培武)
关键词 乡村医生 村卫生室 存在问题 政策建议
中图分类号：R192.3 文献标识码：A 文章编号：1006-1533(2015)04-0016-04
The problems existing in the construction of the rural doctor team and the
, http://www.100md.com
village health stations in Shanghai and policy suggestion
WAN Heping1， JIN Peiwu2
(1.Shanghai Community Health Service Management Center， Shanghai 200040， China; 2.Shanghai Municipal Commission of Health and Family Planning， Shanghai 200125， China)
ABSTRACT The comprehensive security of the rural doctors in Shanghai has been gradually improved and their structure has been constantly optimized. The network of the village health stations at the end is perfect and its operation shows the public welfare. But there exist the problems that the income of the older generation of rural doctors is low， the rank lacks the successors， the career development space for the new generation of rural doctors is limited， and the layout of the village health stations needs optimization， the integration management needs deepening and the service function requires definition at the same time. In the aspect of the rank construction of the rural doctors， it is suggested to strengthen the new rural doctors’ training， expand their career development space and improve the comprehensive security of the older generation of rural doctors. In the aspect of the construction of the village health stations， it is suggested to optimize its layout， to improve the service efficiency at the same time and introduce the internal market mechanism to stimulate the vitality.
, 百拇医药
KEY WORDS rural doctor; village health station; existing problem; policy suggestion
乡村医生是农村最基层的卫生服务人员，村卫生室作为农村三级医疗卫生网的网底，长期以来在维护本市郊区农民健康方面发挥着难以替代的作用。
基本概况
乡村医生
本市乡村医生是指在村卫生室执业的医生，包括老一代乡村医生(简称“老乡医”)和新一代乡村社区医生(特指本市郊区2006年起定向免费培养的具有临床医学大专及以上学历的新一代执业(助理)医师，简称“新乡医”)。截止2014年5月，本市共有老一代和新一代乡村医生共3 492名。
乡村医生性别、年龄构成情况
, http://www.100md.com
男性1 351名，占38.69%，女性2 141名，占61.31%;51～60岁为1 362名，人数最多，占比39.00%，其次是60岁以上697名，占比19.96%，呈现“女多男少、年龄老化”的现况，具体见表1。
乡村医生学历、执业资格构成情况
高中以下人数最多，为1 557名，占44.59%，其次是中专1 201，占34.39%;按执业资格，执业助理医师人数最多，为2 026名，占58.02%，其次是上海市注册乡医875名，占25.06%，总体上素质不高，具体见表2。
乡村医生收入保障方面
新乡医按政策符合条件后纳入社区卫生服务中心编制，享受社区卫生服务中心医务人员同工同酬待遇。老乡医收入保障逐步纳入区县、乡镇整体卫生经费预算，趋向收支两条线管理。如松江区、金山区对乡村医生保障实施区级统筹，区财政托底;其他区县以乡镇为预算主体进行托底保障，呈逐年增长态势。2013年，本市老乡医年收入平均为4.33万元。, 百拇医药(万和平 金培武)