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      Village doctors-supplied public health service and its influencing factors in rural areas of Hebei province


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          Objective To explore the status and causes of imbalance of public health service (PHS) supplied by village doctors in rural areas of Hebei province for making suggestions to development and equalization of PHS in rural areas.

          Methods Using a self-designed questionnaire, we carried out a survey among 800 village doctors recruited with multistage random sampling in 20 towns of 10 counties of 5 municipalities in Hebei province in 2011. Information on basic PHS provided by the village doctors and PHS-related responsibilities of the village doctors were collected, evaluated, and compared.

          Results Of all the village doctors, 732 (91.5%) completed the survey. The average scoring rate for 11 basic PHS items ranged from 68.25% to 80.75%, with an average overall scoring rate of 76.59%. Among the basic PHS items provided by the village doctors, the management on chronic disease was graded the highest score of 3.25 ± 0.73 (scale of 0 – 4) and the identification of Chinese medicinal materials was graded the lowest score of 2.73 ± 1.07. The score for basic PHS items differed significantly by geographical region, the village doctors’ age and whether a village doctor being certificated as a practicing physician or an assistant practicing physician ( P < 0.05 for all). Logistic regression analyses indicated that a village doctor’s sense of responsibility for performing basic PHS was mainly influenced by the doctor’s age, geographical region, education, and whether being certificated as a practicing physician or a assistant practicing physician.

          Conclusion In rural areas of Hebei province, the basic public health service is not evenly performed by village doctors and the evaluation score for public health service is relatively low. The results suggest that measures should be taken to improve the public health service supplied by village doctors for the promotion and equalization of basic public health service.


          【摘 要】 目的 了解河北省乡村公共卫生服务情况,分析公共卫生服务开展不平衡的原因,为乡村公共卫生服务发展和均等化提供建议和意见。 方法 2011 年采用多级抽样的方法从河北省抽取 5 个市、10 个县、20 个乡镇共 800 名乡村医生进行问卷调查,了解基本情况、2011 年实施的基本公共卫生服务、公共卫生责任,并进行评分和比较。 结果 基本公共卫生服务平均得分率为 76.59 %(68.25 %~80.75 %),慢病管理得分最高为(3.25 ± 0.73)分,中医药辨识最低为(2.73 ± 1.07)分。不同年龄、地区、有无执业(助理)医师证书间存在差异( P < 0.05)。logistic 回归分析得出年龄、地区、学历、有无执业(助理)医师证书是公共卫生责任意识的主要影响因素。 结论 开展基本公共卫生服务不平衡,卫生服务得分不高;应加强乡村医院建设和人员培训,转变观念,完善卫生服务规范,加大经费投入,合理分配资源,加强基本公共卫生服务宣传,促进公共卫生服务均衡发展和提高。

          Author and article information

          Chinese Journal of Public Health
          Chinese Journal of Public Health (China )
          01 June 2019
          17 August 2018
          : 35
          : 6
          : 689-692
          [1] 1Chengde Medical College, Chengde, Hebei Province 067000, China
          Author notes
          *Corresponding author: Liang Li, E-mail: lli903@ 123456163.com
          © 2019 China Public Health Editorial Department

          This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

          Journal Article

          Medicine,Nutrition & Dietetics,Occupational & Environmental medicine,Health & Social care,Infectious disease & Microbiology,Public health
          survey,public health service,village doctors


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