【中图分类号】 R192.3 【文献标识码】 ADOI： 10.12114/j.issn.1007-9572.2023.0818

【Abstract】BackgroundWiththenationwide implementationofthe \"Healthy China\"strategy，thehealthdisparities"between urbanandruralpopulationshave narrowed.However，there isstillamismatch between the medicalservicecapacities of villge dctorsandthemedicalsrviceneedsofruralresidents.Villgedoctorsarethefistpointofcontactforruralresidents' health concerns.ObjectiveThisstudyaims to evaluate thecurrent medical service capacitiesof vilage doctors across the eastern，central，and western China，identifytheirstrengthsandweakneses，andproposetargetedstrategiesforimprovement. Thefindings willprovidereferences forbuilding thecapacitiesof primaryhealthcareprofesionals inruralareas.Methods InAugust 2O2O，theresearch groupusedthemixed methodsofmulti-stage stratified clustersamplingandtypicalsampling to select3916vilagedoctorsfromfiveprovincesintheeastern，central，and western China.Bydistributingquestionnairesonthe \"wjx.cn\"platform，anonlinesurveywasconductedonthecurrnt statusof themedicalservicecapacitiesofvilagedoctors from sevenaspects：diagnosisand treatmentofcommonandfrequentlyocuringdiseases，emergencyresponsetocriticalconditions， standardized useof medical devices，communityrehabilitation guidance，medical collaboration，medical document writing， andtraditional Chinese medicineservices.ResultsAmong the3916 village doctors included inthe analysis，2925（ 74.7% ） wereable todiagnoseandtreatcommonandfrequentlyoccurringdiseases.Thecompetenceratesofvillagedoctorsrehighestin the central region（ 81.2% ），followed by the eastern region（ 79.6% ），and lowest in the western region（59.1%）.2 098（53.6 % ） hadtheabilityfemergencyesponsetoricalillnesss.Tecompeteneratesofvilgeoctorsereigstinecentlgion （ 61.6% ），followed by the eastern region（ 52.3% ），and lowest in the western region（ 40.1% ）.2 081（ 53.1% ）could use medical devices inastandardized way.Thecompetence rates ofvilagedoctors were highest in thecentralregion（ 62.3% ）， followed by the eastern region（ 53.8% ），and lowest in the western region（ 36.3% ）. ²⁰⁷³ （ 52.9% ）had the ability to provide community rehabilitation services.The competence rates of villge doctors were highest in the central region（ 59.7% ），followed by the eastern region（ 53.6% ），and lowest in the western region（ 40.3% ）.3120（ 79.7% ）were capable of writing medical documents.The competence rates of village doctors were highest in the central region （ 82.6% ），followed by the eastern region （ 82.0% ），and lowest in the western region（ 72.7% ）.2190（ 55.9% ）possessed the ability of medical collaboration.The competence rates of village doctors were highest in the central region （ 61.0% ），followed by the eastern region（ 57.9% ）， and lowest in the western region（ 45.3% ）.2443（ 62.4% ）were able to provide traditional Chinese medicine services. The competence rates of village doctors were highest in the western region （ 64.8% ），followed by the central region（ 62.7% ），and lowest in the eastern region （ 58.7% ）.ConclusionVillage doctors possess adequate medical service skills，essentially catering tothegeneralmedicalservice nedsofruralresidents.Theoverallmedicalservicecapacitiesshouldbeimproved，andthereexist notablediscrepanciesinmedicalservicecapacitisacrossvariousregions.Itisrecommended tostrengthenthetrainingofvilage doctorsso as to enhancetheoverallqualityof the primaryhealthcare professionals inruralareas，improvetheconstructionof hardwarefacilitiesandinformationtechnologyforvillge-levelmedicalservices，andpromote theefectiveimplementatioofthe first visit systemat the primary health care level.

【Keywords】 Rural doctors；Medical service；Service capacity；Cross-sectional studies

2019年12月，全国人大常委会通过了《基本医疗卫生与健康促进法》［1]，明确强调基层医疗卫生机构和人才队伍建设的重要性。法案规定建立县乡村上下贯通的乡村医疗卫生人员职业发展机制，进一步推动医疗资源的合理配置，以确保城乡居民能够公平可及地获得基本医疗卫生服务，从而巩固基本医疗卫生“网底”[2]村医作为我国卫生专业技术队伍的重要组成部分，是农村基本卫生服务的主要提供者，担负着维护广大农村居民健康的重任。村医作为农村居民健康问题“第一接触点”，其职责包括为村民提供基本医疗和基本公共卫生服务，在家庭签约服务中，既是家庭医生团队的重要成员，更是村民家庭重要的服务提供者和联系人。研究普遍认为，尽管家庭医生的服务是综合性的，但医疗服务则是其最基本和最重要的服务职能，医疗服务既是家庭医生服务的最主要内容[3]，更是家庭医生开展综合性卫生服务的重要保障[4]。具备一定的医疗服务能力是村医执业的基础，也是建设分级诊疗制度的重要基础。

因此，建设一支有良好医疗服务能力的高素质村医队伍，对实现“健康中国”战略，缩小城乡居民间的健康服务差异具有重要意义。目前我国村医队伍仍存在数量不足、年龄老化、卫生服务能力不高等问题，影响农村基层卫生服务的开展。本研究通过对我国村医队伍医疗服务能力的现状进行调研，分析不同地区村医医疗服务能力的差异以及能力分布特征，探讨加强村医队伍建设、提升医疗服务能力的措施，为推动分级诊疗制度的实施提供政策依据和决策支持。……