新医改背景下重庆市璧山区乡镇卫生院人才配置现状分析

新医改背景下重庆市璧山区乡镇卫生院人才配置现状分析(论文16000字)
摘 要
    我国医疗卫生体制改革提出了建立和完善基本医疗卫生制度覆盖城乡居民改革的总体目标。“保证基本,强力基础,构建机制”是核心,实现医疗改革策略。乡镇卫生院是农村三级卫生服务网络的骨干,对绝大多数的主要力量在农村居民提供基本卫生服务。乡镇卫生院的功能和服务能力的高低,“保基本,强基层”改革策略和实施农村居民可以享受基本医疗服务的质量具有重要意义。
    我国乡镇卫生院现有的研究和讨论普遍认为,存在于乡镇削弱错位,轻、重医疗预防保健。缺乏清晰定义的详细乡镇卫生院功能、政府投入不足、卫生人员配置不合理,低水平的能力,缺乏有效的监督检查的主要因素是影响乡镇卫生院功能完美。但是先前的研究仍存在一些问题需要解决：
1)以乡镇卫生院的功能的讨论来查看更多的知识,更多的研究一些功能或任务;
2)现状的分析可以描述更多的动态变化的研究;
3)尽量少支出和融资,并对乡镇卫生院人力资源和功能变化进行综合研究。
新的改革基层卫生机构推出了一系列政策,涉及乡镇卫生院的功能定位、筹集资金和人力资源建设。在这个机会下,乡镇卫生院、资金和人力资源配置更改这些变化将影响乡镇卫生院的服务功能、服务功能变化符合医疗改革的目标,有什么问题,需要进一步的研究。
    本研究的总体目标是:通过调查研究,分析新卫生保健中发现,促进乡镇卫生院资源和服务功能,改善乡镇卫生院的功能,实现强大的基层改革提供政策建议。
    具体的研究目的包括:1)揭示了新医疗改革乡镇财政筹集资金和人力资源的配置更改前后的变化;2)分析新医改前后乡镇卫生院服务功能的变化;3)研究乡镇卫生院服务功能的主要影响因素;4)加强完善新的医疗改革政策和实施提供证据和政策建议。
关键词:医疗改革  乡镇卫生院  力资源建设  医疗服务
 
Medical and health system reform in our country puts forward the establishing and perfecting the basic medical and health system covering both urban and rural residents the overall goals of reform. "Guarantee the basic, strong foundation, build mechanism" is the core, implement health care reform strategy. In towns and townships is the backbone of the rural three-level health service network, for the vast majority of main forces in rural residents to provide basic health services. The function of the towns and townships and the service ability of high and low, "protect the basic, strong grassroots" reform strategy and implementation of rural residents to enjoy basic medical service quality is of great significance.
Our country towns and townships of the existing research and discussion is generally believed that exists in the villages and towns weakening dislocation, light and heavy medical preventive care. The lack of a clear definition, detailed functions in towns and townships, inadequate government, health personnel allocation is unreasonable, the low level of ability, lack of effective supervision and inspection are the main factors of influence in towns and townships function perfect. But previous research there are still some problems need to be solved:
1) discussion on the function of towns and townships to see more and more knowledge, more research some function or task;
2) the analysis of the status quo can be described more dynamic change of research;
3) spending as little as possible and financing, and in towns and townships and the human resource function changes the way of research.
The new reform of basic health authorities introduced a series of policies, involving the towns and townships function orientation, raise funds and human resources construction. Under the opportunity, in towns and townships, capital and human resources configuration changes these changes will affect in towns and townships of service function, service function changes comply with the goals of health reform, have what problem, need further research.
The overall goal of this study is: through the investigation and study, analysis of the new health care found that promote resources in towns and townships and the service function, improve the function of the towns and townships, achieve strong grassroots reform to provide policy recommendations.
Specific research purposes include: 1) reveals the new medical reform of villages and towns finance raising capital and human resources configuration changes before and after the change; 2) analyzing the change of the new towns and townships service function before and after the reform; 3) the study of the function of the towns and townships service main influencing factors; 4) strengthen the perfect new medical reform policy and implementation to provide evidence and policy recommendations.
Keywords: health care reform in towns and townships force resources construction of medical service

目 录
摘 要    I
Abstract    III
目 录    V
1 前  言    1
1.1 新医改的背景    1
1.2乡镇卫生院存在的主要问题    3
1.3研究现状    3
1.3.1乡镇卫生院服务功能研究现状    3
1.3.2乡镇卫生院筹资研究现状    4
1.3.3乡镇卫生院人力资源研究现状    4
1.4研究意义与研究目的    5
1.5论文的结构    5
2.1乡镇卫生院功能研究    7
2.1.1乡镇卫生院历史发展及功能的政策定位    7
2.1.2乡镇卫生院功能的实证研究    9
2.1.3基本卫生服务研究    9
2 .2 乡镇卫生院筹资研究    10
2.3 乡镇卫生院人力资源研究    10
2.3.1人员数量和结构    10
2.3.2人员质量    10
2.3.3 农村地区吸引和留住卫生人才的策略和措施    11
3 资料来源与研究方法    12
3.1理论框架    12
3.2调查方法    13
3.3资料分析方法    13
3.3.1卫生人员基本医疗卫生知识测试方法    14
3.4分析方法    15
3.4.1定性资料分析方法    15
3.4.2定量资料分析方法    15
4 研究结果    16
4.1医改有关乡镇卫生院的政策和政策实施情况    16
4.1.1新医改有关乡镇卫生院的政策    16
4.2样本县(市)经济社会发展    17
4.2.1经济发展    17
4.2.2人口规模及构成    18
4.2.3居民健康状况    18
4.3样本县(市)新医改政策实施及对基层卫生机构的投入状况    20
5 讨论与政策建议    21
5.1方法学讨论    21
5.2对主要结果的讨论    22
5.2.1财政补助投入增加,支付力度增强    22
5.2.2人员数量略有增加,人员结构仍不合理    23
5.2.3人员素质有所提高,但总体水平仍较低    23
5.2.4人员的流失情况有所缓解    24
5.2.5 基本公共卫生服务功能得到强化    24
5.2.6基本医疗服务功能有待进一步加强    24
5.3结论    25
结  论    26
致 谢    27
参 考 文 献    28