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目的:分析相关制度对引导农村居民形成合理就医行为的作用和影响并提出政策建议。方法:现场调查和专家咨询。结果:新医改3年多来,反映基层卫生体系建设的农村卫生人力资源配置问题没有得到实质性解决;基层医疗机构诊疗分布仍然存在不合理的现象;引导居民合理就医最直接有效的制度是全科医生制度和新农合制度,各制度的现实作用与理想情况相比还存在差距。结论:建议以落实全科医生制度建设为契机,促进基层卫生人才的发展;基于各制度之间的作用机制,通过强化医疗机构的分工负责协作机制和政策的协同作用,实现合理就医目标。
OBJECTIVE: To analyze the role and influence of relevant systems in guiding rural residents in forming reasonable medical practices and make policy recommendations. Methods: Field survey and expert consultation. Results: The new medical reform over the past three years, reflecting the primary health care system in rural areas, the allocation of health human resources has not been substantively resolved; basic medical institutions still exist unreasonable distribution of diagnosis and treatment; to guide residents to seek reasonable medical treatment is the most direct and effective system Physician system and the new rural cooperative medical system, the actual role of the system compared with the ideal situation there is still a gap. Conclusion: It is suggested that the construction of general practitioner system should be taken as an opportunity to promote the development of grassroots health personnel. Based on the mechanism of action among the institutions, the division of labor in medical institutions should be coordinated by collaboration mechanisms and policies to achieve the reasonable goal of medical treatment.