关键词: 基层医疗机构, 医疗资源, 卫生服务, 贵州

Abstract: Background　Guizhou issued the 13th Five-Year Plan for Health and Family Planning in Guizhou Province（2016—2020），Three-Year Plan for Improving Serving Capabilities in Primary Care in Guizhou Province（2016—2018），and Outline of the Healthy Guizhou 2030 Plan，in which allocating high-quality medical resources to primary healthcare institutions were put forward to solve the problems of insufficient healthcare resources，serious shortage of talents，incomplete system and mechanism，and weak serving capabilities in primary care sector.Objective　To investigate the status of allocating high-quality medical resources to primary healthcare institutions in Guizhou Province from the perspective of grass-root level medical workers.Methods　This study was conducted in Guizhou Province from September to November 2017.Data of a questionnaire survey〔general personal characteristics（including sex，age，and so on），evaluation of the level of medical services delivered by one's own hospital，understanding and acceptance of allocating high-quality medical resources to primary care，intention of receiving such resources，and effect and problems brought by the implementation of this strategy〕 in a convenience sample of 180 medical workers from 8 primary healthcare institutions selected from Guiyang and Zunyi by use of simple random sampling，and results of in-depth interviews with 17 managers from 17 county-level or lower level medical institutions（cooperation between one's own hospital and higher level hospitals in the construction of a regional medical consortium，delivery of telemedicine and remote care，and hierarchical diagnosis and treatment，the most needed type of medical professionals from higher level hospitals，and conditions provided for such professionals，counterpart assistance from higher level hospitals，and implementation of contracted family doctor services）were analyzed.Results　Altogether，171 primary care providers returned valid responsive questionnaires，obtaining a response rate of 95.0%.Most respondents thought that the level of medical services offered by their own hospital could not satisfy patients' needs，and they thought that allocating high-quality medical resources to primary care institutions was contributive to the development of such institutions，and they were very willing to receive such assistance.The results of interviews with 17 managers are as follows：the operation of a regional medical consortium that their hospital participated in，and the cooperation of their hospital with higher level hospitals in delivering telemedicine and remote care were not ideal；although most patients had initial consultation in primary care，upward referrals were easy to execute，but downward referrals were difficult to implement；the contracted family doctor services were implemented successfully；experienced clinicians，general practitioners and nurses were needed in primary healthcare institutions；their hospital received different levels of counterpart assistance from higher level hospitals.Conclusion　In Guizhou Province，the level of serving capabilities in primary healthcare institutions is unsatisfied and needs to be improved，allocating high-quality medical resources to primary care is still in the initial stage，and the effects of ways of allocation are not good，so related policies need to be developed and supervision of the implementation of allocation needs to be enhanced by the government agencies.

Key words: Primary medical institutions, Medical resources, Medical service, Guizhou