本文關(guān)鍵詞： 鄉(xiāng)村醫(yī)生 養(yǎng)老保障 基層醫(yī)療衛(wèi)生　出處：《山東大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：鄉(xiāng)村醫(yī)生,指的是在我國村級衛(wèi)生室供職的衛(wèi)生工作人員,他們是我國基層衛(wèi)生組織的主力,長期以來為維護(hù)農(nóng)民群眾的生命健康貢獻(xiàn)著自己的力量,其作用不可替代。隨著經(jīng)濟(jì)社會的發(fā)展和醫(yī)改政策的屢次變遷,鄉(xiāng)村醫(yī)生逐漸褪去了曾經(jīng)的光環(huán),新時代帶給他們的,更多的是由于待遇降低、身份尷尬、老無所養(yǎng)、病無所醫(yī)而造成的落魄甚至貧困。在諸多風(fēng)險中,老無所養(yǎng)是他們最為憂心的問題。多年來,雖然全國從上至下呼聲甚高、廣大鄉(xiāng)醫(yī)特別是老年鄉(xiāng)醫(yī)們翹首以盼,但是鄉(xiāng)醫(yī)"養(yǎng)老難"卻遲遲得不到應(yīng)有的解決。2015年3月,國務(wù)院辦公廳印發(fā)了《關(guān)于進(jìn)一步加強(qiáng)鄉(xiāng)村醫(yī)生隊(duì)伍建設(shè)的實(shí)施意見》,對各級政府探索建立健全鄉(xiāng)村醫(yī)生養(yǎng)老機(jī)制提供了較為有力的指導(dǎo)。遵循著中央指導(dǎo)意見,一些省份或地區(qū)相繼進(jìn)行了政策性的探索和實(shí)踐,取得了一定成效。山東是農(nóng)業(yè)人口大省,鄉(xiāng)村醫(yī)生人數(shù)眾多、隊(duì)伍龐大。但多年來,山東省并未制定關(guān)于鄉(xiāng)村醫(yī)生養(yǎng)老保障方面的專門政策,特別是2014年初,在鄉(xiāng)村醫(yī)生養(yǎng)老保障問題久懸不決的情況下,山東省先行出臺了針對老年民辦教師的生活補(bǔ)助政策,對于一直把自身身份與民辦教師等量齊觀的鄉(xiāng)村醫(yī)生來說,"厚此薄彼"的政策待遇更增加了他們的不滿�？梢哉f,養(yǎng)老保障制度的有無和完善程度,正逐漸成為制約及影響山東省鄉(xiāng)醫(yī)隊(duì)伍穩(wěn)定及發(fā)展的主要原因。本文系統(tǒng)梳理了鄉(xiāng)村醫(yī)生的歷史淵源、發(fā)展脈絡(luò),分析了他們在各個時期中發(fā)揮的現(xiàn)實(shí)作用,并以山東省的鄉(xiāng)醫(yī)群體作為研究對象,采取文獻(xiàn)研究法、問卷調(diào)研法、個案訪談法等實(shí)證研究方法,對這一群體的基本狀況、收入水平、養(yǎng)老現(xiàn)狀、崗位歸屬感等情況進(jìn)行了調(diào)查研究。首先對調(diào)研結(jié)果進(jìn)行統(tǒng)計和分析,從而查找出鄉(xiāng)村醫(yī)生養(yǎng)老保障中存在的養(yǎng)老保險類型單一、養(yǎng)老保障水平低下、鄉(xiāng)醫(yī)滿意程度過低等突出問題;然后從鄉(xiāng)村醫(yī)生自身情況、養(yǎng)老保險制度、政府政策、鄉(xiāng)村衛(wèi)生一體化建設(shè)等幾個方面,深入分析造成鄉(xiāng)村醫(yī)生養(yǎng)老難題的原因;最后嘗試從研究制定養(yǎng)老政策、建立完善養(yǎng)老保險制度、提高在崗收入水平、加強(qiáng)隊(duì)伍自身建設(shè)、推動鄉(xiāng)村衛(wèi)生一體化管理等幾個方面,提出較為可行的解決對策,為鄉(xiāng)村醫(yī)生解除老無所養(yǎng)的后顧之憂,為鄉(xiāng)村醫(yī)生隊(duì)伍留住人才,進(jìn)一步夯實(shí)基層醫(yī)療衛(wèi)生的"網(wǎng)底"安全。
[Abstract]:Village doctors refer to the health workers who serve in the village health centers in our country. They are the main force of the primary health organizations in our country and have long contributed their own strength to the maintenance of the life and health of the peasants. With the development of economy and society and the changes of medical reform policy, rural doctors gradually fade the aura of the past, the new era brings them, more because of the reduced treatment, status embarrassment. Old people without care, disease without medical care caused by the loss of soul and even poverty. Among the many risks, the old without a home is their most worried problem. For many years, although the country from top to bottom voice is very high. The majority of rural doctors, especially the elderly, are looking forward to it, but the rural doctors'"pension difficulties" have not been solved as they should be. March 2015. The General Office of the State Council issued and published "opinions on the implementation of further strengthening the Construction of Rural doctors". Government at all levels of exploration to establish and improve the rural doctor pension mechanism to provide more effective guidance. In accordance with the central guidance, some provinces or regions have carried out policy exploration and practice. Shandong is a large agricultural province with a large number of rural doctors and a large contingent. However, for many years, Shandong Province has not formulated a special policy on rural doctors' old-age security. Especially in early 2014, under the condition that the problem of rural doctors' old-age security has not been decided for a long time, Shandong Province first issued the policy of living subsidy for the elderly private teachers. For the rural doctors who have been equal to the private teachers, the policy treatment of "favouring one over the other" has increased their dissatisfaction. It can be said that the pension security system has and improved. It is gradually becoming the main reason of restricting and affecting the stability and development of rural doctors in Shandong Province. This paper systematically combs the historical origin and development of rural doctors and analyzes their realistic role in each period. And take the rural medical community in Shandong Province as the research object, take the literature research method, the questionnaire investigation method, the case interview method and so on empirical research method, to this group basic condition, the income level, the pension present situation. First of all, statistics and analysis of the results of the survey, so as to find out that there is a single type of old-age insurance in rural doctors pension security, the level of old-age security is low. Prominent problems such as the low degree of satisfaction of rural doctors; Then from the rural doctors themselves, pension insurance system, government policies, rural health integration construction and other aspects, in-depth analysis of the causes of rural doctors pension problems; Finally, the author tries to establish the pension policy, establish and improve the pension insurance system, improve the income level in the post, strengthen the team self-construction, promote the integrated management of rural health, and so on. Some feasible solutions were put forward to relieve the worries of the old doctors, to retain the talents and to further strengthen the "net" safety of the primary medical and health care.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.1

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