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中国山东乡村医生提供基本公共卫生服务面临的挑战是什么?一项定性研究。

What Are the Challenges Faced by Village Doctors in Provision of Basic Public Health Services in Shandong, China? A Qualitative Study.

机构信息

School of Health Care Management, Shandong University, 44 Wenhuaxi Road, Li Xia District, Jinan 250012, China.

NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China.

出版信息

Int J Environ Res Public Health. 2019 Jul 15;16(14):2519. doi: 10.3390/ijerph16142519.

Abstract

: Village doctors, as gatekeepers for the health of rural residents in China, are confronted with adversity in providing the basic public health services (BPHS), which has significantly impeded them from providing high quality BPHS. This study aimed to explore the obstacles and difficulties faced by village doctors in order to improve the quality and efficiency of BPHS provision and increase the health level of the population. : In-depth interviews were employed to conduct this qualitative study. A total of 51 village doctors in four cities of Shandong Province were interviewed. The interviews were transcribed, anonymized, and imported into NVivo11.0 to facilitate management. Thematic framework analysis employing the constant comparison method was applied to the data analysis. : The main challenges faced by village doctors comprised the shortage, gender imbalance, and poor education of village doctors; older village doctors in some villages; low income; lack of social security; inappropriate performance assessment; inadequate professional BPHS training; heavy workload; and insufficient cooperation from rural residents, which have exacerbated the quality, efficiency, and accessibility of BPHS to some extent. : Village doctors, as the important BPHS providers in rural Shandong, are facing a wide range of challenges. It is urgent for government officials and policy makers to consider these challenges and concentrate on improving the quality of BPHS provision by developing relevant and practical strategies.

摘要

乡村医生作为中国农村居民健康的“守门人”,在提供基本公共卫生服务(BPHS)方面面临困境,这极大地阻碍了他们提供高质量 BPHS 的能力。本研究旨在探讨乡村医生所面临的障碍和困难,以提高 BPHS 提供的质量和效率,提高人口健康水平。

本研究采用定性研究方法中的深入访谈法。在山东省四个城市共访谈了 51 名乡村医生。访谈内容被转录、匿名化并导入 NVivo11.0 进行管理。采用主题框架分析法和恒定性比较法进行数据分析。

乡村医生面临的主要挑战包括乡村医生数量短缺、性别失衡和教育水平低;部分村庄老年乡村医生较多;收入低;缺乏社会保障;绩效评估不恰当;缺乏专业 BPHS 培训;工作量大;农村居民合作不足,在一定程度上加剧了 BPHS 的质量、效率和可及性问题。

乡村医生作为山东农村重要的 BPHS 提供者,面临着诸多挑战。政府官员和政策制定者迫切需要考虑这些挑战,并通过制定相关和实用的策略,集中精力提高 BPHS 的提供质量。

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