| 引用本文: |
黄冬梅,尹文强,于倩倩,等.我国全科医生资源现状与“2020政策目标”比较分析[J].中国卫生经济,2017,(10):51-55.[点击复制] |
.Analysis on development of China’s General Practitioners human resource during 2012-2015 and its gap with 2020 policy goals[J].CHINESE HEALTH ECONOMICS,2017,(10):51-55.[点击复制] |
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| 摘要: |
| 目的：观察2012以来我国全科医生队伍建设成效和与政策目标的差距。为促进全科医生队伍建设提供参考。方法：利用2013-2016中国卫生和计划生育统计年鉴中的国家和省际数据。用人均资源量和构成比分析全科医生资源在机构、区域和省份间的配置状态；用注册率衡量全科医生职业吸引力；用Pearson相关系数反映各省全科医生资源配置与相关因素的关系。结果：（1）相较于2012年，2015年全科医生资源总量增长了71.8%，但注册率一直低于40%，注册全科医生占执业（助理）医师的2.2%；（2）每万居民拥有的全科医生数量和注册数量分别为1.37人和0.50人；人均资源量东部地区是中西部地区的1.7倍，最高省份是最低省份的7.8倍；最高省份的注册率是最低省份的3.9倍；（3）有83.4%的全科医生分布在基层；2012年每所社区卫生服务机构和乡镇卫生院均拥有培训合格全科医生1名以上，2015年达2名以上，提前完成2020政策目标；（4）每万居民全科医生数量与城镇人口比重、人均GDP、每千居民口基层卫技人员数正相关（r=0.49，0.54，0.56，P均＜ 0.01），注册率与政府卫生投入呈中度相关（r=0.55，P＜ 0.01）；（5）要实现2020政策目标，在保障注册率100%的前提下，人才缺口为107422～229528人；按照最低目标计算人才缺口在5000人以上的省份有11个，按照高目标计算有19个省份人才缺口在5000人以上。按照“每家基层医疗卫生机构均有培训合格全科医生”的政策目标，尚有9省份未达标。经济不发达省份面临更突出的人才储备不足、低注册率和高流失率。结论：全科医生队伍建设面临人才储备总量不足、分布不均、注册率低的三大挑战，凸显医疗服务模式变化不明显、激励政策不到位、职业吸引力有待提高。解决基层卫生人力不足、增加政府卫生投入是全科医生队伍建设的关键。 |
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| Analysis on development of China’s General Practitioners human resource during 2012-2015 and its gap with 2020 policy goals |
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| Abstract: |
| Objective: The paper aims to observe the development of China’s General Practitioners (GP) human resource and its gap with government’s 2020 policy goals. Methods: Using national and provincial data from China health statistics yearbook to calculate the number of GPs per 10000 residents and basic medical institution, GPs’ registration rate and the constituent ratios. Pearson correlation coefficient was used to measure the relationship between GPs allocation and related factors. Results (1) Compared to 2012, the total number of trained GPs in 2015 had an increase of 71.8%, while the registration rate of trained GPs had been below 40%, . (2) The number of trained GPs and registered GPs per 10000 residents were 1.37 and 0.50. The gap between east and middle-west areas is 1.7 times, and that between highest and lowest-allocated provinces was 7.8 times. The registration rate of GPs in highest province was 3.9 times of that in the lowest. (3) 83.4 % of trained GPs were in basic medical institutions, the average number of trained GPs per rural and urban basic institution was 2.14 and 2.17 in 2015. (4) In 2015, the number of trained GPs was positively correlated with the proportion of urban residents, per capita GDP and medical technical personnel in basic institution per 10000 Persons (r=0.64，0.69，0.60，all P＜ 0.01). The registration rate of GPs was positively correlated with the government health input per capita （r=0.55，P＜0.01）. (5). There was a huge gap of 107422～229528 between present trained GPs and the 2020 goal of government’s plan. According the low level of the plan, 11 provinces had a 5000 above gap of trained GPs, while 19 provinces did according the high level of the plan. Those undeveloped areas in the country must struggle to cope with the challenge of less trained GPs, lower registration rate and outflow of trained GPs to developed areas. Conclusion：The development of China’s GPs human resource is confronted with lack of trained GPs, uneven distribution of human resource across the country and low registration rate, which demonstrates the tardy transformation of medical production, lack of incentive for GPs, and the poor attractiveness of GPs’ profession. More practical and powerful incentives are vital to keep and attract top talent into GPs. |
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