An Empirical Study On The Influence Of Medical Professional Background On The Quality Of Medical Services Of Rural Grassroots Doctors

As an important part of human capital,health is an important foundation for personal and social development.The Outline of the "Healthy China 2030 Plan" clearly emphasizes "improving the medical service security system,establishing a medical quality control and management system,and improving the quality of medical services is an important basis for safeguarding people's health and improving people's health.It is of great significance for building a well-off society in an all-round way and accelerating socialist modernization." With the continuous improvement of people's living standards and access to medical services,the quality of medical services has gradually become the focus of people's attention,and rural primary medical institutions,as the main bearers of ensuring the health of rural grassroots people,their medical service quality directly determines the rural grassroots health level of the masses.However,the phenomenon of disorderly prescribing,multiple prescribing,disputes between doctors and patients,and abuse of antibiotics in grass-roots medical institutions in China is widespread,and the quality of medical services is worrying.A lot of research on how to improve doctors'medical service behavior and improve the quality of medical services has become a hot topic for scholars and It has become one of the important contents to promote China's medical service reform and health human capital construction.The medical professional background,as the most basic professional quality of doctors,determines the level of professional knowledge of doctors and affects their medical service behaviors.It is regarded as one of the most important factors affecting the quality of medical services.However,due to the particularity of China's medical system,there are doctors with different professional backgrounds in TCM,western medicine,and Chinese and western medicine in primary-level medical institutions.Professional doctors who should perform their duties are mainly engaged in the diagnosis and treatment of western medicine.This is because both TCM and Chinese and western medicine have theoretical knowledge of western medicine in theory,on the other hand,it is also due to the patients' demand for western medicine treatment and the limitation of related supporting facilities of TCM.However,as two completely different medical systems of TCM and Western medicine,there are significant differences in both professional knowledge and thinking and behavioral methods of diagnosis and treatment.Can doctors of TCM and Chinese and western medicine specializing in the same treatment of Western medicine meet patients' basic western medical treatment needs?Do doctors specializing in Chinese and Western medicine have certain advantages?Does this difference in medical specialty affect the quality of medical services?As an important provider of primary medical services,the quality of TCM' medical services has a direct impact on the health of rural primary patients.However,most studies have focused on the impact of factors such as the drug system,incentive system,and education level on the quality of medical services.Western medicine and other professional backgrounds have rarely covered the study of medical service quality.TCM is an important part of rural primary medical services.The quality of medical services cannot be ignored.It is important to clarify the relationship between different professional backgrounds and medical service quality.The construction of the system is of great significance.Therefore,this paper uses empirical research methods to analyze the impact of professional backgrounds of TCM and Western medicine on the quality of medical services,and explore the mechanism of professional backgrounds of TCM and Western medicines that affect the quality of medical services.The data used in this study are from a survey project conducted by the Shaanxi Normal University Institute of Educational Experimental Economics in 2015 in rural primary medical institutions in the northwest,southwest,and central provinces.This project uses questionnaire interviews to investigate the basic situation of medical institutions and doctors' basic information,and use standardized patient method and clinical situational knowledge method to measure the quality of medical services and clinical knowledge of doctors,aiming to fully understand the status of rural primary medical services.Based on the survey data,the study first describes the current status of medical service quality and clinical knowledge of rural primary doctors;then uses OLS regression models to analyze the impact of professional backgrounds such as Chinese and Western medicine on medical service quality,and explores the impact mechanism;and finally uses propensity score matching(PSM)method performs a robustness test on the impact of different professional backgrounds on medical service quality,and then uses a heterogeneity analysis method to analyze the differences in the impact of assessments and medical training times on medical service quality.Through the above empirical analysis process,the following conclusions are drawn:First,the quality of medical services for rural grassroots doctors is generally poor.Judging from the three indicators of medical service quality,the average rate of completion of diagnosis items for rural primary doctors is 21%,the correct rate of disease diagnosis results is 13%,and the correct rate of disease treatment programs is 31%,of which 69%of treatment programs are harmful or completely ineffective,antibiotics were prescribed in 31%of cases,and there was antibiotic abuse;second,the level of clinical knowledge of rural primary doctors is low.In terms of knowledge of diagnosis items,the completion rate is 25%,the correct rate of knowledge of diagnosis results is 32%,the correct rate of knowledge of treatment plan is 32%,wrong antibiotic use knowledge rate is 24%,and the completion rate or correct rate of knowledge in all aspects is less than 40%;third,Chinese and western medicine professional background has a significant positive impact on the quality of medical services for doctors,and the professional background of TCM has no significant impact on the quality of medical services.Based on the comparison of Western medicine specialty,the background of Chinese and western medicine has a significant positive impact on the proportion of diagnosis items completed and the correct diagnosis results,while the background of TCM has no significant difference in the quality of medical services.Chinese and western medicine background shows the best quality of medical services;fourth,TCM professional background has a significant impact on the use of antibiotic drugs.Compared with western medicine,TCM antibiotics have a higher tendency to use antibiotics.Finally,based on the above research conclusions,combined with the actual situation of rural primary care,the following suggestions are made for improving the quality of rural primary care:(1)Strengthening the construction of medical service quality,focusing on the control of medical service links;(2)Strengthening rural primary care Doctors'knowledge training,focusing on strengthening the basic medical knowledge of doctors with a background in TCM and Chinese and western medicine;(3)Launching targeted management policies for various professional doctors,while comprehensively strengthening the quality of medical services in each specialty,focusing on TCM and Western medicine and Improving their quality of medical services;(4)Strengthening the training of antibiotic side effects for doctors with TCM background to reduce the use of unreasonable antibiotics.