目的：以医疗事故罪判决书为切入点，探讨基层医疗卫生机构存在的问题及应对策略。方法：登录中国裁判文书网，检索近5年医疗事故罪判决书，并对文书内容进行描述性统计分析。结果：2017-2021年的医疗事故罪相关案件集中发生在基层医疗机构。基层医疗机构存在医疗卫生人员学历层次不高、医疗核心制度执行不规范、综合服务能力不足等问题。结论：应重视基层医疗卫生事业的建设发展，以期能够预防医疗事故罪的发生，促进国家基层卫生政策的落实。

Objective：To discuss the problems and countermeasures of primary medical and health institutions from the judgment documents of medical malpractice crime. Methods：The judgment documents of medical malpractice crime in recent 5 years were queried by logging on the China Judgment Documents Network，and the content of the documents were analyzed by the methods of descriptive statistics. Results：The cases related to medical malpractice crime in 2017-2021 were concentrated in the primary medical and health institutions. There are some problems in the primary medical and health institutions，such as the low educational level of medical and health personnel，the non-standard implementation of the core medical system，and the insufficient comprehensive service capacity. Conclusions：Attention should be paid to the construction and development of primary medical and health services，so as to prevent the occurrence of medical malpractice crime，and promote the implementation of national primary health policies.