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Article(id=1321170147881108223, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170080579301694, articleNumber=null, orderNo=null, doi=10.11847/zgggws1146391, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1728576000000, receivedDateStr=2024-10-11, revisedDate=1732032000000, revisedDateStr=2024-11-20, acceptedDate=1735228800000, acceptedDateStr=2024-12-27, onlineDate=1792921109408, onlineDateStr=2026-10-25, pubDate=1736438400000, pubDateStr=2025-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921109408, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921109408, creator=13701087609, updateTime=1792921109408, updator=13701087609, issue=Issue{id=1321170080579301694, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='1', pageStart='1', pageEnd='128', issueExtLink='null', onlineDate='null', pubDate='1736438400000', pubDateStr='2025-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921093363, creator='13701087609', updateTime=1792921093363, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=49, endPage=54, ext={EN=ArticleExt(id=1321170148115989248, articleId=1321170147881108223, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=A survey of training needs for integrated medical, preventive, and managerial key personnel in primary healthcare settings in China, columnId=1320427696342020970, journalTitle=Chinese Journal of Public Health, columnName=Epidemiological Research, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the training needs of primary healthcare professionals with integrated medical, preventive, and managerial skills, and to propose suggestions for optimizing the training of such personnel in China, providing a reference for the implementation of the "14th Five-Year Plan" for National Health.

Methods

In January 2023, a multi-stage sampling method was used to conduct a questionnaire survey on the training needs of 1 641 primary healthcare professionals from community health service centers and township hospitals in 107 prefecture-level cities (autonomous prefectures, districts/counties) across 25 provinces (autonomous regions, municipalities) in China. The survey covered four main areas: basic skills, medical skills, preventive skills, and managerial skills.

Results

Among basic skills, the highest training need was for practicing registration qualifications, at 48.08% (789/1 641). For medical skills, the highest training need was for emergency treatment and pre-hospital first aid, at 46.62% (765/1 641). For preventive skills, the highest training need was for community health service investigation, at 45.52% (747/1 641). For managerial skills, the highest training need was for personnel training and scientific research teaching, at 51.86% (851/1 641). The lowest training need was for the implementation and management of basic public health programs, at 33.88% (556/1 641). Primary healthcare professionals in western regions and township hospitals had higher needs in all areas.

Conclusions

There are regional, urban-rural, and skill-based differences in the training needs of primary healthcare professionals with integrated medical, preventive, and managerial skills in China. It is recommended to coordinate the training of these personnel with the development of village (community) public health committees, clarify their corresponding skill development requirements, and accelerate the standardization process.

, authors=Ying DENG1, Peilin WU2, Yanqing MIAO3, authorsList=Ying DENG, Peilin WU, Yanqing MIAO, authorCompany=null, correspAuthors=Yanqing MIAO, authorNote=null, correspAuthorsNote=
MIAO Yanqing, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321170148573168385, articleId=1321170147881108223, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=我国基层医防管复合型骨干人员培训需求调查, columnId=1320427696509793132, journalTitle=中国公共卫生, columnName=流行病学研究, runingTitle=null, highlight=null, articleAbstract=
目的

了解基层医防管复合型骨干人员的培训需求，并提出优化我国基层医防管复合型骨干人员培养的建议，为落实“十四五”国民健康规划提供参考。

方法

于2023年1月，采用多阶段抽样方法，对我国25个省（自治区、直辖市）107个地级市（自治州、区/县）共1 641名社区卫生服务中心和乡镇卫生院的基层医务人员进行基层医防管复合型骨干人员培训需求问卷调查，调查内容包括基本能力、医疗能力、预防能力和管理能力四个主要方面。

结果

在基本能力中，对执业注册资格的培训需求最高为48.08%（789/1 641）；医疗能力中对急症处理与院前急救的培训需求最高46.62%（765/1 641）；预防能力中对社区卫生服务调查的培训需求最高45.52%（747/1 641）；管理能力中对人才培养与科研带教能力培训需求最高51.86%（851/1 641）；对基本公卫项目实施与管理的培训需求最低33.88%（556/1 641）；西部地区和乡镇卫生院基层医务人员对各方面需求均较高。

结论

我国基层医防管复合型骨干人员的培训需求存在地区差异、城乡差异和能力差异。建议统筹基层医防管复合型骨干人员培养和村（居）委公共卫生委员会建设，明确其相应的能力培养要求，加快标准制定工作。

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邓莹（1978 — ），博士，实验师，研究方向:民商法学、卫生法学

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苗艳青，E-mail：
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邓莹（1978 — ），博士，实验师，研究方向:民商法学、卫生法学

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journalId=1319373219989389464, articleId=1321170147881108223, language=CN, orderNo=2, keyword=医防管骨干人员), Keyword(id=1321170150427050783, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, language=CN, orderNo=3, keyword=培训需求)], refs=[Reference(id=1321170151333020458, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=1, rfOrder=0, authorNames=null, journalName=null, refType=null, unstructuredReference=国务院办公厅. 国务院办公厅关于印发“十四五”国民健康规划的通知[EB/OL]. (2022-05-20)[2024-11-07]. https://www.gov.cn/zhengce/zhengceku/2022-05/20/content_5691424.htm., articleTitle=null, refAbstract=null), Reference(id=1321170151395935019, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=2, rfOrder=1, authorNames=null, journalName=null, refType=null, unstructuredReference=陈家应, 胡丹. 医防融合: 内涵、障碍与对策[J]. 卫生经济研究, 2021, 38(8): 3-5,10., articleTitle=null, refAbstract=null), Reference(id=1321170151471432492, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=3, rfOrder=2, authorNames=null, journalName=null, refType=null, unstructuredReference=丛凡超, 贾仓仓, 李志光. 中国式现代化进程中医防融合的发展路径研究[J]. 卫生经济研究, 2024, 41(10): 6-9., articleTitle=null, refAbstract=null), Reference(id=1321170151542735661, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=4, rfOrder=3, authorNames=null, journalName=null, refType=null, unstructuredReference=张朝阳. “医防管”一体的全面健康管理是农村基层卫生服务的新业态[J]. 中国农村卫生, 2023, 15(1): 22-23., articleTitle=null, refAbstract=null), Reference(id=1321170151605650222, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=5, rfOrder=4, authorNames=null, journalName=null, refType=null, unstructuredReference=屈伟, 陈浩, 郑琪, 等. 医防融合视域下基层公共卫生人才队伍的建设与发展[J]. 中国卫生事业管理, 2021, 38(11): 839-843, 846., articleTitle=null, refAbstract=null), Reference(id=1321170151672759087, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=6, rfOrder=5, authorNames=null, journalName=null, refType=null, unstructuredReference=黄磊, 苗艳青. 疫情防控期间基层医务人员工作状况调查[J]. 中国公共卫生, 2022, 38(5): 582-584., articleTitle=null, refAbstract=null), Reference(id=1321170151744062256, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=7, rfOrder=6, authorNames=null, journalName=null, refType=null, unstructuredReference=张然, 郭岩, 陈浩, 等. 医防融合背景下基层卫生技术人员的培训现状和相关知识需求调查[J]. 现代预防医学, 2022, 49(10): 1912-1920., articleTitle=null, refAbstract=null), Reference(id=1321170151811171121, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=8, rfOrder=7, authorNames=null, journalName=null, refType=null, unstructuredReference=辛宜诺, 彭子轩, 唐小珺, 等. 2012—2021年我国基层医疗卫生人力资源配置效率研究[J]. 中国卫生统计, 2024, 41(4): 616-619., articleTitle=null, refAbstract=null), Reference(id=1321170151869891378, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=9, rfOrder=8, authorNames=null, journalName=null, refType=null, unstructuredReference=朱亚欣, 陈保启, 靳福磊. 我国医疗资源配置效率的地区差异及动态演进[J]. 统计与决策, 2023, 39(24): 78-83., articleTitle=null, refAbstract=null), Reference(id=1321170151945388851, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=10, rfOrder=9, authorNames=null, journalName=null, refType=null, unstructuredReference=民政部, 国家卫生健康委, 国家中医药局, 等. 民政部 国家卫生健康委 国家中医药局 国家疾控局关于加强村(居)民委员会公共卫生委员会建设的指导意见[EB/OL]. (2021-12-31)[2024-11-07]. https://www.gov.cn/zhengce/zhengceku/2022-01/23/content_5670023.htm., articleTitle=null, refAbstract=null), Reference(id=1321170152004109108, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=11, rfOrder=10, authorNames=null, journalName=null, refType=null, unstructuredReference=史全增. 论村委会在重大公共卫生风险防控中的法治化参与路径[J]. 行政法学研究, 2021(3): 37-48., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1321170148837409538, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, xref=1, ext=[AuthorCompanyExt(id=1321170148849992451, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, companyId=1321170148837409538, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1School of Medical Humanities, Capital Medical University, Beijing 100069, China), AuthorCompanyExt(id=1321170148866769668, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, companyId=1321170148837409538, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1首都医科大学医学人文学院，北京 100069)]), AuthorCompany(id=1321170148942267141, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, xref=2, ext=[AuthorCompanyExt(id=1321170148950655750, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, companyId=1321170148942267141, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2School of Government, Beijing Normal University, Beijing 100875, China), AuthorCompanyExt(id=1321170148963238663, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, companyId=1321170148942267141, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2北京师范大学政府管理学院，北京 100875)]), AuthorCompany(id=1321170149038736136, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, xref=3, ext=[AuthorCompanyExt(id=1321170149051319049, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, companyId=1321170149038736136, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3National Health Commission Health Development Research Center, Beijing 100191, China), AuthorCompanyExt(id=1321170149059707658, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, companyId=1321170149038736136, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3国家卫生健康委卫生发展研究中心，北京 100191)])], figs=[ArticleFig(id=1321170150557074208, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, language=EN, label=Tab.1, caption=

Training needs survey items and their explanations for medical, preventive, and managerial key personnel

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维度条目条目解释
基本能力 1.执业注册资格具有全科医学专业的临床（含中医）医师执业资格
2.专业技术资格具有临床（含中医）中级及以上专业技术资格
3.政策法规基础熟悉基层医疗、公共卫生与卫生管理等相关政策、规章、规范
4.基层实践工作具有基层实践工作经历达6年（含6年）以上
医疗能力 5.常见/多发病诊疗提供门诊或病房等临床诊疗服务；掌握基层常见病、多发病的临床表现、诊断和鉴别诊断要点以及处理和健康指导能力
6.慢病早期筛查诊疗掌握高血压、糖尿病、慢阻肺以及冠心病等主要慢性病的高危因素，开展高血压、糖尿病早期筛查；具备主要慢性病稳定期的诊疗处理以及依据病情适时转诊能力
7.急症处理与院前急救掌握基层常见急症、意外伤害及急性中毒的初期处理原则；掌握徒手心肺复苏技术以及包扎、止血、固定、搬运的原则与方法
预防能力 8.“两病”患者健康管理与医防融合熟悉《国家基层高血压防治管理指南》《国家基层糖尿病防治管理指南》和《国家基本公共卫生服务规范》等，实施指导规范开展辖区常住高血压与2型糖尿病患者健康管理；落实医防融合
9. 基本公卫项目实施与管理熟悉国家基本公共卫生服务项目，指导开展各项服务工作指标达到当地卫生健康行政部门指标要求；服务人群知晓率、满意度达到80%以上
10. 传染病与突发公共卫生事件处理熟悉重大传染病和常见传染病疫情防控相关知识，实施指导重大传染病常态化防控工作；开展发热患者筛查以及核酸检测、疫苗接种等各项工作达到要求；传染病与突发公共卫生事件报告率在95%以上；实施指导应急预案演练
11.社区卫生服务调查掌握常用的疾病指标、社区卫生统计指标的含义与计算方法；熟悉对定量或定性资料进行初步统计分析。
管理能力12.学习与信息素养利用各种学习机会，具有多种获取信息渠道，努力学习新技术、新方法更新扩展自己的知识面；能运用现代化信息技术检索、收集、分析、使用各类数据信息
13.人才培养和科研带教关注员工职业生涯发展，制定长期培养人才规划，有计划实现员工自身的个人价值与机构人才梯队建设；带教1～2名下级医生或管理部门下属，取得成效
14.分级诊疗与双向转诊与上级医疗机构、专业公共卫生机构沟通良好，争取技术指导与专业培训，分工协作，逐步实现基层首诊、双向转诊与远程会诊等绿色通道
15.相关部门协调配合争取辖区政府与相关部门支持，获得社区及外部环境支持。参与并技术指导社区公共卫生委员会工作，沟通良好，协调合作，共同完成社区公共卫生各项任务
), ArticleFig(id=1321170150636765985, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, language=CN, label=表1, caption=

医防管骨干人员培训需求调查条目及其解释

, figureFileSmall=null, figureFileBig=null, tableContent=
维度条目条目解释
基本能力 1.执业注册资格具有全科医学专业的临床（含中医）医师执业资格
2.专业技术资格具有临床（含中医）中级及以上专业技术资格
3.政策法规基础熟悉基层医疗、公共卫生与卫生管理等相关政策、规章、规范
4.基层实践工作具有基层实践工作经历达6年（含6年）以上
医疗能力 5.常见/多发病诊疗提供门诊或病房等临床诊疗服务；掌握基层常见病、多发病的临床表现、诊断和鉴别诊断要点以及处理和健康指导能力
6.慢病早期筛查诊疗掌握高血压、糖尿病、慢阻肺以及冠心病等主要慢性病的高危因素，开展高血压、糖尿病早期筛查；具备主要慢性病稳定期的诊疗处理以及依据病情适时转诊能力
7.急症处理与院前急救掌握基层常见急症、意外伤害及急性中毒的初期处理原则；掌握徒手心肺复苏技术以及包扎、止血、固定、搬运的原则与方法
预防能力 8.“两病”患者健康管理与医防融合熟悉《国家基层高血压防治管理指南》《国家基层糖尿病防治管理指南》和《国家基本公共卫生服务规范》等，实施指导规范开展辖区常住高血压与2型糖尿病患者健康管理；落实医防融合
9. 基本公卫项目实施与管理熟悉国家基本公共卫生服务项目，指导开展各项服务工作指标达到当地卫生健康行政部门指标要求；服务人群知晓率、满意度达到80%以上
10. 传染病与突发公共卫生事件处理熟悉重大传染病和常见传染病疫情防控相关知识，实施指导重大传染病常态化防控工作；开展发热患者筛查以及核酸检测、疫苗接种等各项工作达到要求；传染病与突发公共卫生事件报告率在95%以上；实施指导应急预案演练
11.社区卫生服务调查掌握常用的疾病指标、社区卫生统计指标的含义与计算方法；熟悉对定量或定性资料进行初步统计分析。
管理能力12.学习与信息素养利用各种学习机会，具有多种获取信息渠道，努力学习新技术、新方法更新扩展自己的知识面；能运用现代化信息技术检索、收集、分析、使用各类数据信息
13.人才培养和科研带教关注员工职业生涯发展，制定长期培养人才规划，有计划实现员工自身的个人价值与机构人才梯队建设；带教1～2名下级医生或管理部门下属，取得成效
14.分级诊疗与双向转诊与上级医疗机构、专业公共卫生机构沟通良好，争取技术指导与专业培训，分工协作，逐步实现基层首诊、双向转诊与远程会诊等绿色通道
15.相关部门协调配合争取辖区政府与相关部门支持，获得社区及外部环境支持。参与并技术指导社区公共卫生委员会工作，沟通良好，协调合作，共同完成社区公共卫生各项任务
), ArticleFig(id=1321170150708069154, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, language=EN, label=Tab.2, caption=

Comparison of basic competency training needs for medical, preventive, and managerial key personnel in different regions and urban/rural

, figureFileSmall=null, figureFileBig=null, tableContent=
项目内容执业注册资格专业技术资格政策法规基础基层实践工作χ2值P值
有需求无需求有需求无需求有需求无需求有需求无需求
n%n%n%n%n%n%n%n%
地区东部28044.3715825.0426241.5216826.6225840.8913922.0322635.8217627.8916.4420.012
中部21442.1311923.4318736.8113125.7919638.5811121.8517534.4513526.579.2580.160
西部29558.767915.7427654.988717.3326652.998416.7324148.019719.3212.6480.049
χ2值36.37439.81525.27426.267
P值<0.001<0.001<0.001<0.001
城乡社区30740.0819124.9327936.4220727.0228236.8117222.4526534.6020326.5010.9760.089
乡镇48255.0916518.8644650.9717920.4643850.0616218.5137743.0020523.4328.868<0.001
χ2值36.86235.11229.32112.106
P值<0.001<0.001<0.0010.002
), ArticleFig(id=1321170150779372323, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, language=CN, label=表2, caption=

不同地区医防管骨干人员基本能力培训需求比较（人数，占比/%）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目内容执业注册资格专业技术资格政策法规基础基层实践工作χ2值P值
有需求无需求有需求无需求有需求无需求有需求无需求
n%n%n%n%n%n%n%n%
地区东部28044.3715825.0426241.5216826.6225840.8913922.0322635.8217627.8916.4420.012
中部21442.1311923.4318736.8113125.7919638.5811121.8517534.4513526.579.2580.160
西部29558.767915.7427654.988717.3326652.998416.7324148.019719.3212.6480.049
χ2值36.37439.81525.27426.267
P值<0.001<0.001<0.001<0.001
城乡社区30740.0819124.9327936.4220727.0228236.8117222.4526534.6020326.5010.9760.089
乡镇48255.0916518.8644650.9717920.4643850.0616218.5137743.0020523.4328.868<0.001
χ2值36.86235.11229.32112.106
P值<0.001<0.001<0.0010.002
), ArticleFig(id=1321170150854869796, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, language=EN, label=Tab.3, caption=

Comparison of medical capacity training needs for medical, preventive, and managerial key personnel in different regions and urban/rural

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项目内容常见、多发病诊疗慢病早期筛查诊疗急症处理院前急救χ2值P值
有需求无需求有需求无需求有需求无需求
n%n%n%n%n%n%
地区东部26041.2016626.3124038.0317627.8927743.9016325.834.6260.328
中部17734.8413726.9718035.4312825.2019738.7811222.053.9160.418
西部26753.197514.9425951.598717.3329157.977314.545.3160.257
χ2值44.82537.51950.488
P值<0.001<0.001<0.001
城乡社区28036.5519825.8527636.0320626.8930840.2118223.763.9040.419
乡镇42448.4618020.5740346.0618521.1445752.2316618.976.8380.145
χ2值23.69317.73623.712
P值<0.001<0.001<0.001
), ArticleFig(id=1321170150930367269, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, language=CN, label=表3, caption=

不同地区医防管骨干人员医疗能力培训需求比较（人数，占比/%）

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项目内容常见、多发病诊疗慢病早期筛查诊疗急症处理院前急救χ2值P值
有需求无需求有需求无需求有需求无需求
n%n%n%n%n%n%
地区东部26041.2016626.3124038.0317627.8927743.9016325.834.6260.328
中部17734.8413726.9718035.4312825.2019738.7811222.053.9160.418
西部26753.197514.9425951.598717.3329157.977314.545.3160.257
χ2值44.82537.51950.488
P值<0.001<0.001<0.001
城乡社区28036.5519825.8527636.0320626.8930840.2118223.763.9040.419
乡镇42448.4618020.5740346.0618521.1445752.2316618.976.8380.145
χ2值23.69317.73623.712
P值<0.001<0.001<0.001
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Comparison of preventive capacity training needs for medical, preventive, and managerial key personnel in different regions and urban/rural

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项目内容两病患者健康管理
与医防融合		基本公卫项目
实施与管理		传染病与突发公共
卫生事件处理		社区卫生服务调查χ2值P值
有需求无需求有需求无需求有需求无需求有需求无需求
n%n%n%n%n%n%n%n%
地区东部23537.2418028.5319831.3821033.2820232.0121734.3927743.9014522.9835.393<0.001
中部17534.4513426.3814528.5415530.5115330.1215730.9121241.7310520.67108.630<0.001
西部25550.809518.9221342.4311923.7121041.8312224.3025851.399017.9318.0150.006
χ2值36.15429.13424.08012.921
P值<0.001<0.001<0.001<0.001
城乡社区26234.2021728.3324131.4624131.4622929.9025132.7733243.3416821.9343.741<0.001
乡镇40346.0619221.9431536.0024327.7733638.4024528.0041547.4317219.6641.351<0.001
χ2值24.3784.44913.2652.916
P值<0.0010.1080.0010.233
), ArticleFig(id=1321170151077167911, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, language=CN, label=表4, caption=

不同地区医防管骨干人员预防能力培训需求比较（人数，占比/%）

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项目内容两病患者健康管理
与医防融合		基本公卫项目
实施与管理		传染病与突发公共
卫生事件处理		社区卫生服务调查χ2值P值
有需求无需求有需求无需求有需求无需求有需求无需求
n%n%n%n%n%n%n%n%
地区东部23537.2418028.5319831.3821033.2820232.0121734.3927743.9014522.9835.393<0.001
中部17534.4513426.3814528.5415530.5115330.1215730.9121241.7310520.67108.630<0.001
西部25550.809518.9221342.4311923.7121041.8312224.3025851.399017.9318.0150.006
χ2值36.15429.13424.08012.921
P值<0.001<0.001<0.001<0.001
城乡社区26234.2021728.3324131.4624131.4622929.9025132.7733243.3416821.9343.741<0.001
乡镇40346.0619221.9431536.0024327.7733638.4024528.0041547.4317219.6641.351<0.001
χ2值24.3784.44913.2652.916
P值<0.0010.1080.0010.233
), ArticleFig(id=1321170151161053992, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, language=EN, label=Tab.5, caption=

Comparison of managerial capacity of learning and Information literacy, personnel training, scientific research and education, two-way referral of graded diagnosis and treatment, coordination of relevant departments training needs for medical, preventive, and managerial key personnel in different regions and urban/rural

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项目内容学习与信息素养人才培养科研带教分级诊疗双向转诊相关部门协调χ2值P值
有需求无需求有需求无需求有需求无需求有需求无需求
n%n%n%n%n%n%n%n%
地区东部27142.9514623.1430848.8113321.0824839.3015123.9324238.3515825.0417.6570.007
中部21341.9310520.6724748.629418.5017634.6513927.3617334.0613225.9833.554<0.001
西部27454.588416.7329658.967214.3425350.409518.9223747.219518.9216.3050.012
χ2值22.55517.27228.36220.503
P值<0.001 0.002<0.001<0.001
城乡社区32742.6916821.9334745.3016020.8928336.9518624.2826935.1219024.8021.872<0.001
乡镇43149.2616719.0950457.6013915.8939445.0319922.7438343.7719522.2942.937<0.001
χ2值7.12924.79411.83912.980
P值0.028<0.001 0.003 0.002
), ArticleFig(id=1321170151240745769, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170147881108223, language=CN, label=表5, caption=

医防管骨干人员管理能力培训需求（人数，占比/%）

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项目内容学习与信息素养人才培养科研带教分级诊疗双向转诊相关部门协调χ2值P值
有需求无需求有需求无需求有需求无需求有需求无需求
n%n%n%n%n%n%n%n%
地区东部27142.9514623.1430848.8113321.0824839.3015123.9324238.3515825.0417.6570.007
中部21341.9310520.6724748.629418.5017634.6513927.3617334.0613225.9833.554<0.001
西部27454.588416.7329658.967214.3425350.409518.9223747.219518.9216.3050.012
χ2值22.55517.27228.36220.503
P值<0.001 0.002<0.001<0.001
城乡社区32742.6916821.9334745.3016020.8928336.9518624.2826935.1219024.8021.872<0.001
乡镇43149.2616719.0950457.6013915.8939445.0319922.7438343.7719522.2942.937<0.001
χ2值7.12924.79411.83912.980
P值0.028<0.001 0.003 0.002
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我国基层医防管复合型骨干人员培训需求调查
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邓莹 1 , 吴佩林 2 , 苗艳青 3, *, *
中国公共卫生 | 流行病学研究 2025,41(1): 49-54
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中国公共卫生 |流行病学研究 2025 , 41 (1) : 49 -54
我国基层医防管复合型骨干人员培训需求调查
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邓莹1, 吴佩林2, 苗艳青3, *, *
作者信息
  • 1首都医科大学医学人文学院，北京 100069
  • 2北京师范大学政府管理学院，北京 100875
  • 3国家卫生健康委卫生发展研究中心，北京 100191
通讯作者:
苗艳青，E-mail：
作者简介:

邓莹（1978 — ），博士，实验师，研究方向:民商法学、卫生法学

A survey of training needs for integrated medical, preventive, and managerial key personnel in primary healthcare settings in China
Ying DENG1, Peilin WU2, Yanqing MIAO3
Affiliations
  • 1School of Medical Humanities, Capital Medical University, Beijing 100069, China
  • 2School of Government, Beijing Normal University, Beijing 100875, China
  • 3National Health Commission Health Development Research Center, Beijing 100191, China
    • Corresponding Author:
    MIAO Yanqing, E-mail:
出版时间: 2025-01-10 doi: 10.11847/zgggws1146391
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摘要
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目的

了解基层医防管复合型骨干人员的培训需求，并提出优化我国基层医防管复合型骨干人员培养的建议，为落实“十四五”国民健康规划提供参考。

方法

于2023年1月，采用多阶段抽样方法，对我国25个省（自治区、直辖市）107个地级市（自治州、区/县）共1 641名社区卫生服务中心和乡镇卫生院的基层医务人员进行基层医防管复合型骨干人员培训需求问卷调查，调查内容包括基本能力、医疗能力、预防能力和管理能力四个主要方面。

结果

在基本能力中，对执业注册资格的培训需求最高为48.08%（789/1 641）；医疗能力中对急症处理与院前急救的培训需求最高46.62%（765/1 641）；预防能力中对社区卫生服务调查的培训需求最高45.52%（747/1 641）；管理能力中对人才培养与科研带教能力培训需求最高51.86%（851/1 641）；对基本公卫项目实施与管理的培训需求最低33.88%（556/1 641）；西部地区和乡镇卫生院基层医务人员对各方面需求均较高。

结论

我国基层医防管复合型骨干人员的培训需求存在地区差异、城乡差异和能力差异。建议统筹基层医防管复合型骨干人员培养和村（居）委公共卫生委员会建设，明确其相应的能力培养要求，加快标准制定工作。

基层  /  医防管骨干人员  /  培训需求
Objective

To understand the training needs of primary healthcare professionals with integrated medical, preventive, and managerial skills, and to propose suggestions for optimizing the training of such personnel in China, providing a reference for the implementation of the "14th Five-Year Plan" for National Health.

Methods

In January 2023, a multi-stage sampling method was used to conduct a questionnaire survey on the training needs of 1 641 primary healthcare professionals from community health service centers and township hospitals in 107 prefecture-level cities (autonomous prefectures, districts/counties) across 25 provinces (autonomous regions, municipalities) in China. The survey covered four main areas: basic skills, medical skills, preventive skills, and managerial skills.

Results

Among basic skills, the highest training need was for practicing registration qualifications, at 48.08% (789/1 641). For medical skills, the highest training need was for emergency treatment and pre-hospital first aid, at 46.62% (765/1 641). For preventive skills, the highest training need was for community health service investigation, at 45.52% (747/1 641). For managerial skills, the highest training need was for personnel training and scientific research teaching, at 51.86% (851/1 641). The lowest training need was for the implementation and management of basic public health programs, at 33.88% (556/1 641). Primary healthcare professionals in western regions and township hospitals had higher needs in all areas.

Conclusions

There are regional, urban-rural, and skill-based differences in the training needs of primary healthcare professionals with integrated medical, preventive, and managerial skills in China. It is recommended to coordinate the training of these personnel with the development of village (community) public health committees, clarify their corresponding skill development requirements, and accelerate the standardization process.

primary healthcare  /  medical, preventive, and managerial key personnel  /  training needs
邓莹, 吴佩林, 苗艳青. 我国基层医防管复合型骨干人员培训需求调查. 中国公共卫生, 2025 , 41 (1) : 49 -54 . DOI: 10.11847/zgggws1146391
Ying DENG, Peilin WU, Yanqing MIAO. A survey of training needs for integrated medical, preventive, and managerial key personnel in primary healthcare settings in China[J]. Chinese Journal of Public Health, 2025 , 41 (1) : 49 -54 . DOI: 10.11847/zgggws1146391
正文
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以基层为重点，提高基层防病治病和健康管理能力，促进基层医疗卫生服务体系高质量发展，关键是培养复合型骨干人员需求的复合型人员。《“十四五”国民健康规划》中明确提出“为每个乡镇卫生院和社区卫生服务中心培养1～2名具备医防管等能力的复合型骨干人员”[1]。落实新时代党的卫生与健康工作方针，培养具有医防管等能力的复合型骨干人员是推进医防融合的重要举措[2–3]，是完善基层医疗卫生机构功能、落实辖区居民防治一体化健康管理的创新尝试。鉴于此，了解我国基层医防管复合型骨干人员的培训需求，提出优化基层医防管复合型骨干人员培养的对策建议，为落实“十四五”国民健康规划的相关要求提供参考依据。
1　对象与方法
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1.1　对象
于2023年1月采用多阶段整群抽样方法， 对我国25个省（自治区、直辖市）的107个地级市（自治州、区/县）的社区卫生服务中心和乡镇卫生院进行问卷调查。根据国家统计局划分标准，本研究东部地区包括：北京市、上海市、天津市、浙江省、江苏省、山东省、广东省、福建省；中部地区包括：山西省、湖南省、湖北省、安徽省、河南省、江西省、黑龙江省；西部地区包括：重庆市、四川省、甘肃省、贵州省、云南省、广西壮族自治区、宁夏回族自治区、陕西省、内蒙古自治区、青海省。被调查机构的主要负责人、分管业务负责人、科室（家庭医生签约服务团队）负责人及医防护等卫技人员自愿填写调查问卷。共收回问卷1 703份，其中有效问卷1 641份，问卷回收有效率96.36%。
1.2　方法
采用自行设计的调查问卷通过“问卷星”平台进行在线调查。调查问卷的整体Cronbach′s α系数为0.83，问卷信度较好。调查内容包括：（1）个人基本情况：调查对象的年龄、性别、学历和岗位聘任等信息；（2）基层医防管复合型骨干人员基本能力培训需求情况，主要涉及执业注册资格、专业技术资格、政策法规基础和基层实践工作4个主要方面；（3）医疗能力培训需求情况，涉及基层常见/多发病诊疗、慢病早期筛查诊疗和急症处理与院前急救3个主要方面；（4）预防能力培训需求情况，包括“两病”（高血压、糖尿病）患者健康管理与医防融合、基本公卫项目实施与管理、传染病与突发公共卫生事件处理和社区卫生调查4个主要方面；（5）管理能力培训需求情况，包括学习与信息素养、人才培养和科研带教、分级诊疗与双向转诊和相关部门协调配合等4个主要方面。各条目详细信息见表1。培训需求从“非常大”到“非常小”按Likert-5级量表进行选择。调查前所有调查对象均知情同意。为确保问卷质量，问卷中部设有逻辑测试题，并在正式调查前进行预调查，记录问卷平均填写时间。正式分析前，剔除未通过逻辑测试题、答卷时间不足3 min或超过10 min、所有选项均一致的无效问卷62份。
1.3　统计分析
使用Excel 2016建立数据库，利用SPSS 22.0进行一般描述性分析并进行组间差异性检验，双侧P<0.05为差异有统计学意义。
2　结　果
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2.1　基本人口学特征
有效调查的1 641人中，男性935人（56.98%），女性706人（43.02%）；平均年龄（42±7.84）岁，年龄主要分布在40～49岁（45.83%）；机构主要负责人（中心主任/卫生院院长）521人（31.75%），分管业务负责人（中心副主任/卫生院副院长）403人（24.56%），科室负责人200人（12.19%），卫技人员517 人（31.51%）；有医学专业学历1 580人（96.28%），临床执业类别784人（49.62%），中医类别253人（16.01%），护理类别283人（17.91%），医技类别128人（8.10%），其他类别81人（5.13%），公卫类别51人（3.23%）；高级职称394人（24.01%），中级职称564人（34.37%），初级职称527人（32.11%），无职称156人（9.51%）。
2.2　医防管骨干人员基本能力的培训需求（表2）
整体而言，对执业注册资格的培训需求最高为48.08%（789/1 641），其次是专业技术资格44.18%（725/1 641）、政策法规基础43.88%（720/1 641），最低为基层实践工作经历需求39.12%（642/1 641）。从不同维度来看，基本能力各维度下培训需求均为西部高于东部和中部，乡镇卫生院高于社区卫生服务中心，差异均具有统计学意义（ P<0.05）。从不同地区来看，东部和西部地区对执业注册资格的培训需求最高，分别为44.37%（280/631）和58.76%（295/502）；中部地区对各维度的培训需求较均衡。乡镇卫生院对执业注册资格的培训需求最高为55.09%（482/875），对基层实践工作的需求最低43.09%（377/875），差异均具有统计学意义（χ2=28.868，P<0.001）。
2.3　医防管骨干人员医疗能力的培训需求（表3）
整体而言对急症处理院前急救的培训需求最高为46.62%（765/1 641），其次是常见、多发病诊疗的能力需求42.90%（704/1 641），最低为慢病早期筛查诊疗能力需求41.38%（679/1 641）。从不同维度来看，各维度下培训需求均为西部高于东部和中部，但中部需求低于东部需求。乡镇卫生需求远高于社区卫生服务中心，且差异具有统计学意义（P<0.005）。
2.4　医防管骨干人员预防能力培养的需求（表4）
对社区卫生服务调查的培训需求最高为45.52%（747/1 641），其次是“两病”（高血压、糖尿病）患者健康管理与医防融合能力的培训需求40.52%（665/1 641），传染病与突发公共卫生事件处理的培训需求34.43%（565/1 641），基本公卫项目实施与管理的培训需求为33.88%（556/1 641）。从不同维度来看，各维度下培训需求均为西部高于东部和中部，乡镇卫生院高于社区卫生服务中心，差异均具有统计学意义（P<0.05）。地区内、同类机构均对社区卫生服务调查表达了较高培训需求；东部和中部对基本公卫项目实施与管理能力培训需求较低，分别为31.38%（198/631）和28.54%（145/508），且差异具有统计学意义（χ2=35.393，P<0.001；χ2=108.63，P<0.001）；西部对传染病与突发公共卫生事件处理需求最低41.83%（210/502），差异有统计学意义（χ2=18.015，P=0.006），但西部对社区卫生服务调查能力的培训需求最高，这就反映了西部基层医务人员在基本的卫生服务能力调查知识方面较为欠缺。社区卫生服务中心对传染病与突发公共卫生事件处理的需求最低29.90%（229/766），差异有统计学意义（χ2=43.741，P<0.001），但对于社区卫生服务调查的培训需求最高；乡镇卫生院则对基本公卫项目实施与管理需求最低36.00%（315/875），差异亦有统计学意义（χ2=41.351，P<0.001）。
2.5　医防管骨干人员管理能力的培训需求（表5）
总体看，对人才培养与科研带教能力的培训需求最高为51.86%（851/1 641），其次是学习与信息素养能力46.19%（758/1 641），分级诊疗与双向转诊41.26%（677/1 641），最低为与相关部门协调配合39.73%（652/1 641）。从不同维度来看，各维度下培训需求均为西部最高，东部次之，中部地区的培训需求最低；城乡比较，乡镇卫生院显著高于社区卫生服务中心，差异具有统计学意义（P<0.005）。
3　讨　论
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培养符合基层岗位需求的复合型骨干人员是落实新时代“以基层为重点”卫生与健康工作方针的具体举措，是贯彻落实健康优先发展战略的基本要求[4]。本研究从基本能力、医疗能力、预防能力和管理能力4个维度的15个方面调查了我国25个地区的1 641名基层医务人员对医防管等能力的培训需求。调查结果显示，就基层医防管骨干人员能力培训需求而言，在基本能力方面，对执业注册资格的培训需求比例最高为48.08%（789/1 641），可见全科医生的执业资格获取是基层医务人员成为医防管复合型骨干人员最重要的条件之一，与屈伟等[5]的调查结果一致；医疗能力方面，基层对于急症处理与院前急救的培训需求最高46.62%（765/1 641），表明急症处理与急救能力是基层当前的薄弱环节，急需加强；预防能力方面，基层对社区卫生服务调查的培训需求最高45.52%（747/1 641），其次是“两病”患者健康管理与医防融合能力的培训需求为40.52%（665/1 641），但基层对于传染病防控方面的培训需求反而不高，这可能与疫情期间基层医务人员进行了真正的实战训练有关[6]；管理能力方面，对人才培养与科研带教能力培训需求最高，但与相关部门配合协调能力的培训需求最低，仅为39.73%（652/1 641），这一培训需求意愿低恰恰反映了基层医疗卫生机构管理者对于培养医防管复合型骨干人员的目标、战略意义并没有完全理解，未将加强基层治理能力建设与基层医防管骨干人员培养结合起来认识。
分地区和分城乡看，西部对各方面能力的培训需求均较强烈；相较于社区卫生服务中心，乡镇卫生院对各方面能力的培训需求较强烈，与张然等[7]的研究结果一致，这主要是由于当前我国医疗卫生资源配置不均导致的，更多优质医疗卫生资源集中在东中部地区和城区[8–9]。西部地区、乡镇卫生院均对人才培养与科研带教（58.96%、57.60%）、执业注册资格（58.76%、55.09%）和急症处理与院前急救（57.97%、52.23%）等培训需求较高，对基本公卫项目实施与管理的需求相对较低（42.43%、36.00%）。值得注意的是，中部地区的培训需求意愿反而没有东部高，这可能与东部的经济发展水平以及对于基层治理复杂化、多元化与专业化认识程度有关。
综上，为基层培养医防管复合型骨干人员是贯彻落实党的二十届三中全会精神，更好实施健康优先发展战略的战略性举措。结合本次调查结果，提出以下建议：第一，培养基层医防管复合型骨干人员要明确其在村（居）公共卫生委员会中的职责，逐步实现法治化。《中华人民共和国宪法》第111条第2款规定，村民委员会设公共卫生委员会，办理本居住地区的公共事务和公益事业。《关于加强村（居）民公共卫生委员会建设的指导意见》进一步明确了公共卫生委员会成员应包含基层医疗卫生机构医务人员[10]，培养基层医防管复合型骨干人员立足于夯实公共卫生委员会的队伍建设，符合宪法根本要求，有利于强化村委会在重大公共卫生风险防控中法治化责任[11]。各级党委政府需加强重视，统筹基层医防管复合型骨干人员培养与村（居）委公共卫生委员会建设。第二，明确基层医防管骨干人员的能力培养要求。突出实战性和实效性，结合岗位需求，以提高基层医防管骨干人员解决和处置实际问题的能力为目标，制定培养大纲和课程设置，医疗能力方面重点以重点慢病诊治和传染病识别为主，预防能力以社区卫生服务调查和影响因素识别为主，管理能力以加强与外系统部门的沟通协调，应急突出能力为主。第三，加快制定基层医防管复合型骨干人员标准工作，为推动医防管复合型骨干人员培养和全面发展提供法治保障，最终为推动社会共治、医防协同、医防融合的卫生健康事业发展奠定人才储备基础。

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doi: 10.11847/zgggws1146391
  • 接收时间：2024-10-11
  • 首发时间：2026-10-25
  • 出版时间：2025-01-10
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  • 收稿日期：2024-10-11
  • 修回日期：2024-11-20
  • 录用日期：2024-12-27
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    1首都医科大学医学人文学院，北京 100069
    2北京师范大学政府管理学院，北京 100875
    3国家卫生健康委卫生发展研究中心，北京 100191

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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