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在1986年前,我县卫生工作较为落后,医疗技术水平和资源利用率都较低。有的区卫生院病床使用率只有10％,治愈率只有70％;乡卫生院病床使用率平均只有34％。村卫生组织不巩固,开展预防保健工作困难大,区、乡党政领导对卫生工作职责也不明确。为了深化卫生改革,强化农村卫生工作的管理,从1986年起,在县委县府的领导和支持下,我们对农村卫生工作实行了双轨责任制。经过3年的实践,收到了很好的效果。现将“双轨责任制”的内容及效果评价介绍如下: 责任制模式责任制形式县政府与区公所签订农村卫生工作责任书;区公所与乡(镇)政府签订责任书,并将任务分解到区卫生院和乡政府。乡政府又将任务分解到乡卫生院和村委会。县卫生局与县、区医疗卫生单位签订责任书;区卫生院
Before 1986, the health work in our county was relatively backward, and the level of medical technology and resource utilization were relatively low. In some district hospitals, the utilization rate of beds was only 10%, and the cure rate was only 70%; the average occupancy rate of hospital beds in township hospitals was only 34%. Village health organizations are not consolidating, and it is difficult to carry out preventive health care work. The responsibility of party and government leaders in districts and townships for health work is also not clear. In order to deepen health reform and strengthen the management of rural health work, we have implemented a dual-track responsibility system for rural health work since 1986 under the leadership and support of the county government. After 3 years of practice, it has received very good results. The content and effect evaluation of the “dual-track responsibility system” is now described as follows: Responsibility system model Responsibility system The county government and the District Office sign the rural health work responsibility book; the district office and the township (town) government sign a responsibility statement and break down the tasks. District health centers and township governments. The township government also decomposed the task to the township health center and the village committee. The County Health Bureau signed a letter of responsibility with the county and district medical and health units; district hospitals