社工服务的对象主要为弱势群体，面对危机时，他们更容易陷入困境而不能 摆脱。疾病就是一个很严重的威胁。在中国因病致贫，因病返贫的家庭更是有着 许多，老百姓看病、看病难已经成为公认的社会问题。作为社工，除了政策方面 的帮助，支持以及事件发生后救助，我们如何才能从根源上解决这一问题，笔者 认为预防保健是个很好的途径。“治未病”，防患于未然，做好预防免疫，环境卫 生，饮食营养，身体锻炼等等就可以将疾病扼杀在萌芽状态，不至于造成危机。 相对于得病后治疗、康复的成本，预防保健花费的成本、代价则小得多。因此， 预防保健引起了笔者的关注，笔者认为社会工作介入预防保健可以有效促进该问 题的解决。因为社区是居民生活的一个重要场所，社区预防保健可以更方便快捷 的为社区居民提供服务。在集“预防，治疗，保健，康复，健康教育，计划生育” 六位一体的社区卫生服务体系中，预防保健是重要基础。所以笔者认为社会工作 介入社区预防保健将成为社工介入预防保健的可行路径。因此笔者通过文献研 究，个案访谈的研究方法，了解居民对预防保健的迫切需求，以及中国预防保健 服务发展的现状。通过中国卫生统计年鉴的数据，引出社会工作介入预防保健的 迫切性以及社会工作介入预防保健领域的关键问题。最后得出社会工作介入预防 保健领域的有效可行路径—社会工作介入社区预防保健。 关键词 ，预防保健 社工介入 生态系统理论 社区预防保健V Abstract Social work services mainly for the disadvantaged groups, when faced with a crisis, they are more likely to get into trouble and could not get rid of. Disease is a serious threat. In China the poverty due to illness, return deficient due to illness in the family have many more, common people to see a doctor, difficulty has become recognized as the social problems. As a social worker, in addition to policy help, support and events that occur after the rescue, how can we fundamentally solve this problemThe author thinks that the preventive health care is a very good way. Preventive treatment of disease, nip in the bud, do a good job of preventing immune, environmental health, diet, physical exercise and so can be disease nipped in the bud, not causing crisis. Relative to the disease treatment, rehabilitation, prevention and health care costs, cost much less. Therefore, preventive health caused the author 's attention, the author thinks that the intervention of social work in prevention and health care can effectively promote the solution of this problem. Because the community is an important place for residents, community prevention and health care can be more convenient for community residents to provide services. In the episode the prevention, treatment, care, rehabilitation, health education, family planning six in one of the community health service system, preventive health care is an important foundation. So the author thinks that the community prevention and health care will become the social involvement of prevention and health care the feasible path. Therefore, the author through literature research, case study method, to understand the residents of the preventive health care needs, as well as the current situation of the development of Chinese preventive health services. . by China health statistical yearbook data, leads to social work intervention of prevention and health care and social work intervention is the key issues in the field of prevention and health care. Came to the conclusion that the intervention of social work in prevention and health care fields effective feasible path on community prevention and health care. Key Words ， Preventive health care Social work intervention Ecological system theory Community prevention and health careVI 目录 1 绪论.............................................................................................................................................1 1.1 研究的背景和意义..........................................................................................................1 1.2 研究对象的界定..............................................................................................................2 1.2.1 社会工作.............................................................................................................2 1.2.2 预防保健.............................................................................................................3 1.3 文献综述..........................................................................................................................5 1.3.1 预防保健存在的问题.........................................................................................5 1.3.2 预防保健的实践方法和路径.............................................................................6 1.3.3 国外社工介入预防保健的经验模式.................................................................6 1.4 研究框架和内容..............................................................................................................7 1.5 研究方法和资料来源.....................................................................................................8 1.5.1 研究方法.............................................................................................................8 1.5.2 资料来源.............................................................................................................9 2 预防保健的现状及其问题.......................................................................................................10 2.1 不同医疗保障制度下预防保健的需求——基于典型个案的访谈...........................10 2.1.1 新农合下农民预防保健需求迫切...................................................................10 2.1.2 公费医疗下的生命健康亦需要保障...............................................................12 2.1.3 商业医疗保险下的居民亦需要预防保健.......................................................15 2.2 中国预防保健服务的现状............................................................................................18 2.2.1 预防保健服务的开展情况...............................................................................18 2.2.2 社会工作介入预防保健的现状.......................................................................23 2.3 预防保健存在的问题...................................................................................................24 2.3.1 从业人员欠缺...................................................................................................24 2.3.2 服务的可及性不足...........................................................................................26 2.3.3 特殊人群的需求难以满足...............................................................................27 3 社会工作介入预防保健的可行性及其路径...........................................................................28 3.1 社会工作介入的必要性...............................................................................................28 3.1.1 预防保健从业人员急需补充...........................................................................28 3.1.2 提高预防保健的可及性...................................................................................28 3.1.3 提升特殊人群需求的满足程度.......................................................................29 3.2 社会工作介入的可行性...............................................................................................29 3.2.1 核心理念相通...................................................................................................29 3.2.2 国外经验模式的借鉴.......................................................................................30 3.3 社会工作介入的路径...................................................................................................31 3.3.1 社工介入社区卫生服务中心...........................................................................31 3.3.2 社工介入 NGO 的预防保健服务.......................................................................33 4 结语...........................................................................................................................................35