乡镇卫生院管理体制改革的探索

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一、原管理体制的缺陷 对乡镇卫生院管理,我县经历过三个阶段、三种管理体制。第一阶段:50年代中期,由个体医生自愿组合、自筹资金创建联合诊所,主要由县卫生协会管理。第二阶段:50年代后期到80年代后期,联合诊所改为卫生院,转由县卫生局管理。第三阶段:80年代后期,将乡卫生院交乡政府管理。这三种管理体制各有特点,都适应了当时社会经济状况,对促进农村卫生事业发展发挥了重要作用。但也暴露出一些缺陷和问题。 由县卫生局单独管理乡镇卫生院有以下缺陷:一是部分卫生院管不到。县卫生局是县卫生行政机关,要管理全县的医疗、卫生、预防、保健、教学、科研、中医事业、卫生执法等,工作繁重,又只有十几个编制,全县有57个乡镇,3 200平方公里地域,卫生局不可能对每一个乡镇卫生院都能进行具体的指导、监督, I. Defects of the original management system For the management of township hospitals, our county has experienced three stages and three types of management systems. The first phase: In the mid-1950s, a joint clinic was created by self-employed individual volunteers and self-raised funds. It was mainly managed by the county health association. The second phase: from the late 50s to the late 1980s, the joint clinic was changed to a health center and transferred to the county health bureau. The third stage: In the late 1980s, the township hospitals were managed by the township government. These three kinds of management systems have their own characteristics, have adapted to the socio-economic conditions at that time and played an important role in promoting the development of rural health services. However, some defects and problems have also been exposed. The township hospitals managed by the county health bureau alone have the following deficiencies: First, some hospitals cannot. The county health bureau is the county health administrative agency. It has to manage the county’s medical, health, prevention, health care, teaching, scientific research, traditional Chinese medicine, and health law enforcement. The work is arduous and there are only a dozen or so preparations. There are 57 townships in the county. In the area of ​​3,200 square kilometers, it is impossible for the health bureau to provide specific guidance and supervision for each township hospital.
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