ABSTRACT
Objective To analyze the current situation and influencing factors for the inflow and outflow of village doctors. Methods The stratified random sampling method was used to collect data on the flow of village doctors from 2010 to 2015. Thirty-six townships were sampled, which were located in 12 counties from 6 provinces in the eastern, central and western China respectively. Results The average age of sampled village doctors was 31. 25 ± 8. 75 years, and most of them graduated from technical secondary school(57. 21% ). The outflows were greater than the inflows, and the net inflow in the eastern region was highly negative. Among the outflows, those under 60 years old accounted for 44. 78%, and most of them went to medical institutions of higher level. 22. 26% of the outflows were under 40 years old, while 85. 42% of them had college degree or above, and 71. 72% were practicing(assistant) physicians. Conclusions The main force of village doctors is draining, with replenishment difficult to attract. Income and career prospects are the main causes for the loss. A model of rural doctors is thus recommended, combining such major elements as capabilities, motivations and opportunities for reinforcement of the teambuilding.
ABSTRACT
Township and Village Health Services Integration Management (TVHSIM) is an essential form of China's two-tiered health service integration plan at the township and village level.Its main purpose,also one of the target goals in China's new healthcare reform,is to gradually integrate rural health services and appropriately allocate rural health resources.This study aims to assess the village doctors' satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM.A cross-sectional study was carried out in which 162 village doctors from Qinghai,Inner Mongolia and Xinjiang in western China were interviewed.Descriptive analysis,independent t-test,one-way ANOVA,Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors' personal characteristics and their satisfaction with TVHSIM and six subscales.Village doctors with different years of practice,social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels (all P＜0.05).Age (P＜0.05) and years of practice (P＜0.01) were negatively correlated with Drug and Medical Device Management and Financing Management.Essential medical knowledge level (P＜0.05) was negatively correlated with Operations Management as well.However,social insurance status (P＜0.05) was positively correlated with Human Resources Management and Drug and Medical Device management.Gender,age and years of practice respectively had significant influence on village doctors' satisfaction with TVHSIM (P＜0.01).In conclusion,in order to further promote TVHSIM policy in rural China,a well-rounded social insurance model for village doctors is urgently needed.In addition,the development of TVHSIM is regionally imbalanced.Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.
ABSTRACT
Objective To survey village doctors'knowledge,demand and behavior of health management,to provide scientific evidence for village people's health self-management.Methods Prepared a self-designed question-naire and make it completed by 106 village doctors chosen at random from 106 different villages in the eight towns in Guangzhou's two mountainous districts.Results The average age of the village doctors was(50.9 1 ±7.84)years, 36.79% of them had the ultimate diploma of a health technical school,and the average knowledge rate of health man-agement was 30.09%.There was remarkable difference among the 3 age groups which disclosed statistic value(χ2 =112.900,P =0.000).The 35-44 age group was the highest in the knowledge rate of health management (52.61%). The doctors with a ultimate technical diploma vary in the knowledge rate (the highest was 47.44%),which also had statistic value(χ2 =112.900,P =0.000).Only 2.83% of the village doctors believed that their health management skill can completely meetthe current demand and 3.77% can.18.87% believed that training about health management was very meaningfuland 25.47% meaningful.63.21% (most required by the health bureau) expected to receive training.16.98% didn't receive such training in the recent year because they thought it was un-necessary or not available.11.32% of the village doctors were willing to pay for the health management training,while 97.17% had never taken such training on their own expenses.Conclusion Village doctors are mostly elderly,low-educated,and insufficient in the professional knowledge of health management.Without the corresponding motivations and regulations,they are not enthusiastic about the training.It is suggested that the local authorities pay more attention to the buildup of the village health stations and improve the structure,knowledge,and earning of the village doctor group so as to ensure the effective health management service for the masses in villages.