Investigation on Community Health Management Ability of Rural Doctors in China

Abstract

Background As the gatekeepers for rural residents' health, rural doctors are the main providers of health management services for rural populations. Their community health management ability directly affects the health level of rural residents. Objective This study aims to investigate the current status of health management ability of rural doctors in China and explore strategies for enhancing their community health management ability, thus providing a basis for strengthening the building of a rural doctor team. Methods In August 2020, a multi-stage stratified cluster sampling and purposive sampling methods were used to select 3 916 rural doctors from five provinces in east, central, and western China. Rural doctors were surveyed using an online questionnaire platform called "Wenjuanxing". The questionnaire content included the rural doctors' ability to manage the health of children, women, elderly, and chronic disease patients, and the degree to which these needs were met, all of which were self-evaluated by the rural doctors. Results Of the 3 916 rural doctors surveyed, 3 494 (89.22%), 3 175 (81.08%), 3 775 (96.40%), and 3 738 (95.45%) were found to had the ability to manage the health of children, women, the elderly, and patients with chronic diseases, respectively. The ability of female rural doctors to provide family planning guidance, prenatal health guidance, prevention and treatment of menopause-related diseases, and screening for common gynecological diseases was better than that of male rural doctors (P<0.05) ; while the male village doctors had a higher rate of identifying and handling common chronic disease critical conditions, stable and regular treatment of common chronic diseases, prevention of complications, and health management abilities for chronic disease patients compared to female village doctors (P<0.05). Rural doctors with qualifications of medical practitioners or assistant medical practitioners had a higher proportion of those with the ability to prevent and treat menopause-related diseases than those with qualifications of rural practitioners and other qualifications (P<0.008 3). Rural doctors with qualifications of medical practitioners or assistant medical practitioners had a higher proportion of those with the ability to manage women's overall health than those with qualifications of rural practitioners (P<0.008 3). Rural doctors with qualifications of general practitioners had a higher proportion of those with the ability to manage the functional decline of the elderly among than those with qualifications of rural practitioners (P<0.008 3). Rural doctors with a bachelor's degree or above had a higher proportion of those with the ability to provide stable-period treatment and prevention of chronic diseases than those with a junior college diploma (P<0.017). Rural doctors in the eastern region of China had a higher proportion of those whose ability to guide the physical examination and screening for common diseases of the elderly meets the actual work needs than those in the central and western regions, and the proportion in the central region was higher than that in the western region, with statistically significant differences (P<0.017). Rural doctors in the eastern and central regions of China had a higher proportion of those whose ability to assess the health and self-care ability of the elderly, identify and intervene with negative emotions, and prevent functional decline met the actual work needs than those in the western region (P<0.017) . Conclusion At present, rural doctors in China basically had the ability to manage health, and female rural doctors had an advantage in providing women's health management services. However, rural doctors with qualifications of rural practitioners lack the ability to manage the health of some specific key populations, and the ability of rural doctors in the western region to manage the health of the elderly is relatively poor. Therefore, active measures should be taken to improve the quality of rural doctors and promote the stability and sustainable development of the rural doctor team.

Keywords

• rural doctors|rural health services|health management|clinical competence|public health services