Effect Evaluation And Action Mechanism Analysis Of Centralized On-site Training On Knowledge And Behavior Of Village Doctor

China is in a transition stage of population ageing and economic development.The promotion of rural residents’ human health capital is a major driving force to realize social equity’s development and keep economy’s sustainable development.As the frontline"guard" of rural residents’ health,the village doctor’s human capital level,especially medical knowledge and clinical diagnosis,plays a key role in rural residents’ health.So promoting village doctor’s medical knowledge and clinical diagnosis is an inevitable requirement to facilitate the equity of rural and urban residents’ human health capital.Centralized on-site training,as one of important means of human capital investment,has been widely used to enhance village doctors’ professional skill by our country.Compared with the doctors in county-level hospitals,rural doctors have significant differences in personal characteristics,business scope,relevant incentive system.The validity of centralized on-site training on China’s village doctors still lacks positive evidences.Existing relevant research indicates,on one side,the application of centralized on-site training is rarely focused in rural areas;on the other side,a lack of scientific assessment on village doctors’ medical knowledge and clinical diagnosis results in difficulty to accurately evaluate the training’s effect.The research’s purpose is to take 330 clinics in Yunnan as example,evaluate the existing centralized on-site training’s effect on village doctors’ medical knowledge and clinical diagnosis,analyze its mechanism of action,thus provide scientific positive evidences and policies for making medical and health policy measures,enhancing quality of rural medical services.Therefore,the research uses experimental economics’ randomized intervention experiment to divide 330 village doctors into intervention group and contrast group,in which there 110 village doctors in intervention group and 220 village doctors in contrast group accepting an intervention of centralized on-site training.Based on the randomized intervention experiment,centralized on-site training’s effect on village doctors has been evaluated and analyzed.The specific research contents include:（1）description on village doctors’ current situation and rural medical service quality’s relevant factors;（2）Centralized on-site training intervention’s effect on village doctors’medical knowledge and clinical diagnosis;（3）Analyze centralized on-site training intervention’s mechanism of action on village doctors’ medical knowledge and clinical diagnosis.The conclusions of the research include:（1）Our country’s village doctors are not optimistic in quality,tend to be aged and low in educational level.Gender,years of medical service,education background,qualification of Professional Assistant Doctor or Professional Doctor,net medical income,the number of rural clinics within 5 square kilometres are notable factors affecting village doctors’ medical service quality.（2）Centralized on-site training could only improve village doctors’ medical knowledge and clinical diagnosis to some extent:enhancing village doctors’ medical service quality by the indexes of necessary inquiry and completion rate of examination items,but no notable impact on diagnosis result’s accuracy and treatment plan’s suitability.（3）From the perspective of economic factor,higher net medical income will raise the training’s marginal value,village doctors have greater power to learn,thus training effect has been enhanced:the centralized on-site training on high-income village doctors remarkably has enhanced their medical knowledge level.From the perspective of non-economic factor,especially personality characteristics,personality characteristics is a notable factor to influence centralized on-site training’s effect.For example:training on highly neurotic village doctors could remarkably enhance their necessary inquiry in knowledge presentation and completion rate of examination items;Training on highly conscientious village doctors could remarkably enhance treatment plan’s accuracy rate in knowledge test;Training on highly noble village doctors could remarkably reduce the probability of unnecessary treatment in clinical diagnosis.Based on the conclusions above,this article proposes that village doctors’ medical service quality and human capital issue should deserve more attention while promoting rural residents’ human health capital.The effect of existing centralized on-site training is not satisfactory,to improve the training’s effect,both economic and non-economic factors should be taken into consideration.On one side,incentive system should be improved while centralized on-site training’s running,thus drive village doctors to have greater power to learn;On the other side,differentiated training should be emphasized,because doctors’ personality characteristics makes a great difference as well.