Rational distribution of health human resources that can keep,use and manage is the key process to strengthen the rural three-level health service network,and to be sure,the sense of identity plays a pivotal role in it.This study,with qualitative research of sociology and research in historic culture,analyzed the influence of the status quo of social,cultural and historical background on rural doctors as health human resource.Through the field observation and individual in-depth interview,it explored the current condition of relationship mode and interaction way behind village life,analyzed the influences of them upon health human resource,and put forward some suggestions to adapt rural culture environment,following the view of existence determines consciousness of historical materialism.

Objective To study the impact of policy external environmental changes on rural doctors'ranks,and to find out the adaptability between the two.Methods The purposeful sampling method was used to study 84 people of district H in Beijing by means of both field observation and individual in -depth interviews from July to August in 2016.The data acquired was analyzed by qualitative method, and interview results were categorized and analyzed by citing typical expressions of the respondents.In October 2016,rural doctors from 260 village clinics in 14 townships in district H were subject to a basic information survey,by means of general description.Results The changes of village governance model, strength of personal relationship made in adaptation between health policy and policy environment,retained the practice of senior village doctors.These people,though low in competence,were advantageous as being locals(237 of them being in the same village)and for their familiarity with health conditions, namely family disease history and diet habits,of local villagers.At the same time,health policies were not adaptive to the policy environment,as village committees tend to ignore management of doctors.12 of the 21 village leaders were not involved in the management.Conclusions Development of rural doctors ranks is highly challenging as making policies friendly to external policy environment, and the constraints of such environment on health policies deserves more attention.

Objective:To understand the satisfaction of villagers on the service of village clinics,in order to improve the service ability of village clinics.Methods:Choosing M County of Beijing as the research site,we chose five towns and chose 10 villages in each town as the studysites.In the extraction 50 villages,about 5 villagers from each village were selected to conducts questionnaire survey.Results:Of the villagers surveyed,the average age was (55.99 ± 11.71)years old.A total of 75.0％ of the villagers chose to seek medical care in village clinics when they had common diseases.The order of the number of people that villagers were satisfied with the village clinicsin all aspects from high to low was drug quality,basic medical care,public health,the type and quantity of drugs,medical equipment.Conclusion:It should give priority to the introduction of the village talent and weave tertiary health care network bottom tightly;pay attention to hardware equipment at basic level and tamp the service status of village clinics;give consideration to both the benefit and public welfare and improve health service ability.

Objective:To investigate the correlation of rural doctors' service ability and interest demands,and analyze the countermeasures for improving the service capacity of rural doctors from the perspective of the personal interest demands of rural doctors. Methods:Through the combination of qualitative and quantitative research meth-ods,we described the current situation and correlation of rural doctors'service ability and interest demands. Result:The interest demands of rural doctors mainly included raising the level of old - age insurance,increasing economic subsidies,clarifying the position of rural doctors,increasing the training opportunities and solving practice risk. These five demands had different level effect on the service ability of rural doctors. Conclusion:It should compre-hensively promote the progress of rural integration,improve the rural doctor's economic subsidies and pension secu-rity level and integrate rural doctor into medical and health system;establish a rural doctor' risk sharing mechanism to solve the practice risk of rural doctors;optimize the training mechanism for rural doctors to improve the technical level of rural doctors.

Objective:To understand the relationship between life style and chronic disease in rural area. Meth-ods:With purpose sampling method,a total of 60 villagers with chronic diseases in 14 administrative villages in 3 townships in H district were conducted field observation and in - depth individual interview. Interview contents in-cluded the chronic disease of villager,villagers' daily eating habits and composition,the living condition,and the medication situation of patients with chronic disease and so on. Results:The surveyed villagers' chronic disease was closely related to life style,and the too long time of leisure and unreasonable diet structure were the core fac-tors. Conclusion:Healthy life style should be combined with the local property and diet custom. It should use the method of "adjusting measures to local conditions" rather than" copying",put forward villager' s acceptable and feasible life style,abandon daily life,diet structure and other behaviors that influence health,and effectively inter-vene the occurrence and development of disease,to truly improve the health level of villagers.

Objective To survey the service status of rural doctors in Beijing suburb.Methods Twenty one village officials,21 rural doctors and 42 local residents from 21 villages in Beijing Huairou district were selected with purposive sampling method as the objects of this qualitative study.The service status of rural doctors was assessed from four aspects:basic public health service,basic medical service,management ability,responsibility and communication ability.Results All the 21 village clinics provided basic public health services,including hypertension management (100.0％),diabetes management (100.0％);11 clinics (52.4％) also provided vaccination services.Eighteen village doctors (85.7％) assisted township health center to provide signing health service,but were lack of knowledge about the types of service the general practitioners (GPs) should provide.The well performed basic medical services among 21 village clinics included diagnosis and differential diagnosis of common diseases in 19 (90.5％) clinics,home visits in 18 (85.7％) and physical examinations in 15 (71.4％),but the service like trauma management,changing dressing,subcutaneous injection,intravenous infusion were performed less well.The top three most satisfied aspects in the medical service were the service attitude (4.14 points),the quality of service (3.98 points) and service time (3.66 points),and the bottom three were equipment facilities,the types and varieties of drug,and the environment of clinics.In aspect of emergency service,7 village doctors (33.3％) would choose self-referral by patients without preliminary on-site emergency treatment,5 (23.8％) would give on-site emergency treatment before self-referral by patients.In aspect of training needs,18 (42.9％) local residents and 9 (42.9％) village officials considered that it was not necessary to provide training for village doctor because of relatively older age.In aspect of patient's satisfaction,21 village doctors (100.0％),21 village officials (100.0％) and 34 villagers (81.0％) considered that the village doctor had a high professional sense of responsibility and medical ethics,and their doctor-patient communication skills were strong.Conclusion The survey reveals the current service status of village doctors in Beijing suburb,and it is necessary to take comprehensive measures to upgrade the competence of village doctors and to improve the quality of service in village clinics.