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双柏县是一个多民族的国家级贫困山区县。据大庄乡１６５户、８０４人的家庭卫生服务调查，两周每百人患病人数２１．８９，因病休工、休学８３．３天。农民自报１９９４年人均医药费用８５．６３元，占人均纯收入３２５元的２６．３％，负担过重。对大庄乡基层卫生机构的费用研究表明，１９９５年次均门诊费用，村级４．１５元、乡级１１．５２元，乡卫生院次均住院费用５９１．８１元。１９９５年大庄乡农民人均纯收入４３０元。医疗服务费用增长速度远高于农民人均纯收入增长速度。１９９０～１９９５年农民人均纯收入平均年增长率１４．２％；次均门诊服务费用平均年增长率，村级１８．０％，乡级３２．４％；乡卫生院次均住院费用平均年增长率４１．４％。大庄乡中心卫生院收入与支出分析结果表明，政府投入并不少，１９９０～１９９５年财政拨款占总收入的３１．７％，占纯收入的５８．８％，平均年增长率２１．６％，超过双柏县人均国内生产总值平均年增长率１６．７％。支出中主要为人员费３９．６％，药品费４８．８％。过快增长的医疗费用主要是药品费用，制约了农民对医疗服务的利用，带来了乡卫生院门诊和住院工作量的下降，浪费了有限的卫生资源。作者对发展贫困农村基层卫生事业，提出了?
Shuangbai County is a multi-national state-level poverty-stricken mountain county. According to a survey of 165 households and 804 people in Da Zhuang Township, the number of patients per 100 people in the two weeks was 21.89, and they were off work and left school for 83.3 days. Farmers reported that per capita medical expenses in 1994 were 85.63 yuan, accounting for 26.3% of the per capita net income of 325 yuan, and they were overburdened. The research on the cost of primary health facilities in Dazhuang Township indicated that in 1995, the average outpatient expenses were 4.15 yuan for the village level, 11.52 yuan for the township level, and 591.81 yuan for the hospitalization fee for the township hospital. In 1995, the per capita net income of farmers in Da Zhuang Township was 430 yuan. The growth rate of medical service costs is much faster than the per capita net income of farmers. From 1990 to 1995, the average annual growth rate of per capita net income of farmers was 14.2%; the average annual growth rate of average outpatient service fees was 18.0% at the village level, 32.4% at the township level; The growth rate is 41.4%. The results of the income and expenditure analysis of the Dazhong Township Central Hospital show that the government has invested a lot. From 1990 to 1995, the financial appropriation accounted for 31.7% of the total income and 58.8% of the net income, with an average annual growth rate of 21.6%. Exceeds the average annual growth rate of the average annual GDP per capita of Shuangbai County by 16.7%. Expenditure mainly includes 39.6% of personnel expenses and 48.8% of medical expenses. The excessively rapid increase in medical expenses is mainly due to the cost of medicines, which restricts the use of medical services by farmers, brings about a decline in the outpatient and inpatient workload of township health centers, and wastes limited health resources. The author proposes to develop poverty-stricken rural grassroots health undertakings?