| Objective:Through the investigation and analysis of the basic situation of village clinics in some villages in Gansu Province and the service capabilities and service status of village doctors,the service situation of rural doctors in Gansu Province was understand.To provide a theoretical basis for the establishment of a rural community health service system and human resources that meet our province’s actual needs.Method:Based on the research objectives and the geographic,geomorphological,geographic location,and traffic conditions of Gansu Province,a multi-stage cluster sampling method was adopted in 2016 to select Gaotai County,Zhangye City,Linxi County,Tianshui City,Wushan County,and Weinan City,Wen County,Gansu Province.A total of 1,132 administrative villages in Ning County of Qingyang City were investigated.Each county investigated all village clinics and all rural doctors under the jurisdiction of the county.According to the literature data and the purpose of this study,the"Country doctor’s survey form for village health offices in Gansu Province","Survey of rural residents’satisfaction degree in Gansu Province"and an interview outline for rural doctors were designed.The survey questionnaire was designed to consult and assess the content and structure of the questionnaires at the Grassroots Division of the Health and Welfare Commission of Gansu Province,the Gansu Provincial Center for Disease Control and Prevention,and five experts from the Public Health College of Lanzhou University.The questionnaire used the reliability test to measure the questionnaires.The reliability and validity of the assessment,Before the investigation,rural doctors and 30 rural residents in 30 village clinics in Gansu were randomly selected to conduct pre-surveys.Surveys were conducted 15 days later.The validity of the last calculated questionnaire was 0.86,and the coefficient was 0.80,indicating the validity and reliability of the questionnaire.better.This survey was conducted in advance to train investigators.Face-to-face direct interviews and self-preparation methods were used to collect data.Epidata 3.1software was used to create databases.Double entries were entered and checked and corrected.All data were analyzed using SPSS 22.0.Results:(1)A total of 1132 questionnaires were distributed in this survey.According to the previously set quality control standards,1120 valid questionnaires were finally included.The questionnaires recovery rate was 98.93%.The average area of 1120village clinics was 62.37±12.05 m~2,of which 60-100m~2 accounted for 58.7%,and the area was less than 60%accounted for 35.9%;the average number of beds in 1120village clinics was 2.03±0.11,and the number of beds in village clinics was 1-3.The proportion of beds is 84.5%,which meets the requirements of the national health room beds.The government funding for the construction of village clinics accounted for 47.9%of the total,health centers and village committees contributed 19.9%,government subsidies for villages and township hospitals accounted for 12.8%,and village doctors accounted for 11.0%of government subsidies,all of them Contributions accounted for 8.4%,and only one health room accounted for 62.4%in rural areas.(2)1120 rural doctors,924(82.5%)were men and 196(17.5%)were women.The gender ratio was 4.71:1;the average age of rural doctors was 50.27±10.38,and the maximum was 72 years old.At the age of 22,41.6%of rural doctors were aged41-60 years old,and the average age of rural doctors was 23.21±6.55,of which 21-30years accounted for 35.5%;from the academic point of view,rural doctors and college graduates accounted for 162(14.5%),829 secondary school students(74.0%).846people(75.5%)have a rural doctor certificate.In terms of education and training,78.1%of rural doctors participate in 1-3 training sessions each year.(3)The number of village doctors who carried out 5-10 health education programs each year accounted for 46.1%,44.5%of village clinics were developed less than 5 times;the rate of health records created by Gaotai County village clinics in5 sample counties has been 88.1%,84.9%in Ning County,83.3%in Wen County,81.4%in Wushan County and 81.0%in Linyi County.(4)The village clinics that implement the charging standards set by the higher authorities are taking up 83.9%;in 2016,the number of outpatient clinics in the village clinics is more than 1,000,accounting for 52.1%,and 49.3%of the village clinics have annual income of 1-3 million yuan.In terms of individual monthly income,69.0%of village doctors’monthly income is between 1000 and 2,000 yuan.Ninety-five percent of village doctors participate in new rural pension insurance,new rural cooperative medical care,and rural pension insurance,but there are still 5%of village doctors without any insurance.(5)The satisfaction survey included a total of 965 villagers,with 393 males(40.7%)and 572 females(59.3%),with an average age of 62.32±16.19.There were379(39.8%)of the population above 60;The rate was 80.5%,the drug price satisfaction rate was 83.7%,the hospital satisfaction rate was 83.5%,the basic medical service satisfaction rate was 74.0%,and the public health service satisfaction rate was 70.5%.(6)Using the Health Service Demand Act,we calculated the ratio of basic medical services and basic public health provided by rural doctors and found that the required adjustments of medical personnel required by each sample count were(person/ten thousand people):Gaotai County,22.30,Wushan County,20.26,Linyi County,18.90,Wen County,16.56,Ning County,20.22.Conclusion:(1)The service status of village clinics,such as infrastructure construction,environmental conditions,and fees,are mostly in line with China’s community health regulations.(2)The basic medical service capacity of village doctors is relatively low,and there is still a certain gap between the basic medical services and public health services in rural areas and the requirements of the state;and rural residents’satisfaction with the hardware conditions of village clinics is still not satisfactory.(3)Using the Health Service Demand Act,calculate the number of rural doctors needed by each 10,000 population in each sample counted area.The demand from high to low is Gaotai County(22.30),Wushan County(20.26),Ning County(20.22),and Linyi County(18.90).),Wen County(16.56). |
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