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

摘要： 背景　为解决贵州省基层医疗卫生资源总量不足、人才严重匮乏、体制机制不健全、服务能力薄弱等问题，贵州省“十三五”卫生计生事业发展规划、贵州省基层医疗卫生服务能力三年提升计划及“健康贵州2030规划”等提出贵州省优质医疗资源下沉基层的目标。目的　了解基层医务工作者视角下贵州省优质医疗资源下沉现状。方法　于2017年9—11月采用简单随机抽样法从贵阳市和遵义市选取8家基层医疗机构，采用方便抽样法抽取180例医务人员，进行问卷调查。问卷内容包括：性别、年龄等基本情况，对本院医疗服务技术水平的评价，对优质医疗资源下沉的了解度、意愿及接受度，认为优质医疗资源下沉基层产生的影响及存在的问题。采取立意抽样法选取17例县级及以下医疗机构负责人进行深入访谈。访谈内容包括：所在基层医疗机构与上级医院建立医联体、远程医疗及分级诊疗情况，最需要上级医院中哪类医务人员下沉，能为下沉人员提供什么条件，能否得到上级医院的对口帮扶，家庭医生签约服务开展实施情况。结果　基层医疗机构医务人员调查问卷共发放180份，共收回有效问卷171份，问卷有效回收率为95.0%。多数基层医疗机构医务人员认为基层医疗机构医疗技术水平不能满足各种患者需求，基层医务人员欢迎优质医疗资源下沉基层且认为优质医疗资源下沉对基层医疗机构是有利的。17例县级及以下医疗机构负责人认为医联体和远程医疗整体实施效果不理想，基层患者大部分会选择在基层医疗机构首诊，双向转诊存在上转容易下转难问题，家庭医生签约服务工作较好，基层医疗机构缺乏经验丰富的临床医生、全科医生以及护士等医务人员，所在基层医疗机构得到上级医院不同程度的对口帮扶。结论　基层医疗机构医疗卫生服务水平需提升。贵州省优质医疗资源下沉处于起步阶段，各种下沉方式效果不佳，需要政府及相关部门出台有关政策并加大监督力度。

关键词: 基层医疗机构, 医疗资源, 卫生服务, 贵州