乡村振兴战略背景下上海村级医疗机构人才队伍建设调查分析

常佩瑶 张安 杨超 张天晔 王冬 孙继佳 汪铭涵 李连香 高中制

摘 要 目的：為了解乡村振兴战略背景下村级医疗机构人才队伍建设情况，于2016年、2020年对上海市村级医疗机构与乡村医生的现状进行调查，为进一步完善上海市村级医疗机构人才队伍建设提供建议。方法：于2016年6月选取上海市9个区的1 224家村级医疗机构进行问卷调查，共发放问卷1 224份，回收有效问卷1 224份，问卷有效回收率100.0%。于2020年6月选取上海市9个区的1 449家村级医疗机构进行问卷调查，共发放问卷1 449份，回收有效问卷1 449份，问卷有效回收率100.0%。结果：与2015年相比，新乡村医生的占比有所上升，差异有统计学意义（P<0.001）。与2015年相比，2019年本科及以上学历的乡村医生占比有所上升，差异有统计学意义（P<0.05）。与2015年相比，2019年上海乡村医生中具有执业医师资格的占比有所上升，具有执业助理医师资格的占比有所下降，差异均有统计学意义（P<0.05）。浦东新区未来3年需求的乡村医生缺口数量最大，与已培养人数相差75名，青浦区已毕业的定向培养乡村医生流失率较高，达7.4%。结论：应将乡村医生纳入家庭医生服务团队，为社区居民提供综合、连续、全程的健康管理服务。发挥乡村医生在社区卫生服务平台中的作用，调动乡村医生的工作积极性，逐步形成社区卫生服务中心对乡村医生进行任务分派、绩效考核、薪酬分配的管理对接机制，同时建立以标化工作量为依据的薪酬机制，逐步提升乡村医生收入。

关键词 村级医疗机构；乡村医生；人才队伍建设

中图分类号：R197.6 文献标志码：A 文章编号：1006-1533（2021）12-0015-04

Investigation and analysis of talent team construction of village level medical institutions in Shanghai under the background of rural revitalization strategy

CHANG Peiyao1， ZHANG An1， YANG Chao2， ZHANG Tianye2， WANG Dong2， SUN Jijia1， WANG Minghan1， LI Lianxiang1， GAO

Zhongzhi1

（1. School of Public Health， Shanghai University of Traditional Chinese Medicine， Shanghai 201203， China； 2. Primary Health Care Department of Shanghai Health Committee， Shanghai 200125， China）

ABSTRACT Objective： To understand the situation of talent team construction of village level medical institutions under the background of rural revitalization strategy， the current situation of village level medical institutions and rural doctors in Shanghai was investigated in 2016 and 2020， respectively， so as to provide suggestions for further improvement of the talent team construction of village level medical institutions in Shanghai. Methods： In June 2016， 1 224 village level medical institutions in 9 districts of Shanghai were selected to conduct a questionnaire survey， a total of 1 224 questionnaires were distributed and 1 224 valid questionnaires were recovered， with an effective recovery rate of 100.0%. In June 2020， 1 449 village level medical institutions in 9 districts of Shanghai were selected to conduct a questionnaire survey， a total of 1 449 questionnaires were distributed， and 1 449 valid questionnaires were recovered， with an effective recovery rate of 100.0%. Results： Compared with 2015， the proportion of new rural doctors increased， and the difference was statistically significant （P<0.001）. Compared with 2015， the proportion of rural doctors with bachelor degree or above increased in 2019， and the difference was statistically significant （P<0.05）. Compared with 2015， in 2019， the proportion of rural doctors with the qualification of licensed doctors increased in Shanghai， while the proportion of rural doctors with the qualification of licensed assistant doctors decreased， and the differences were statistically significant （P<0.05）. The number of rural doctors needed in Pudong New District in the next three years was the largest， which was 75 less than the number of trained doctors； the turnover rate of rural doctors who had graduated in Qingpu District was high， up to 7.4%. Conclusion： Rural doctors should be included in the family doctor service team to provide comprehensive， continuous and whole process health management services for community residents； the role of rural doctors in the community health service platform should be brought into play， and the work enthusiasm of rural doctors should be mobilized， so as to gradually form a management docking mechanism of task assignment， performance appraisal and salary distribution for rural doctors by the community health service center， and at the same time， the salary mechanism based on standardized workload should be established to gradually increase the income of rural doctors.

KEY WORDS village level medical institution； rural doctor； talent team construction

国务院印发的《乡村振兴战略规划（2018—2022年）》（2018年第29号）[1]指出，全面建成小康社会和全面建设社会主义现代化强国，最艰巨最繁重的任务在农村，最广泛最深厚的基础在农村，最大的潜力和后劲也在农村。农村基层医疗卫生服务的质量决定了基本医疗卫生服务的可及性、公平性和农村地区居民的卫生健康状况。上海市卫生健康委员会于2019年3月发布的《2019年上海市基层卫生工作要点》[2]中提出，应按照乡村振兴战略规划的统一部署，继续开展岗位培训，持续提升乡村医生业务能力。

村级医疗机构是指承担村级公共卫生和基本医疗服务的农村社区卫生服务站、村卫生室（所、站）等医疗卫生机构[3]。为了解乡村振兴战略背景……