摘要
目的:观察2012年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: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71.82%,但注册率一直低于40.00%,注册全科医生占执业(助理)医师的2.20%;(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83.46%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,注册率与政府卫生投入呈中度相关;(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。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。
Objective： To observe the development of China＇s General Praetitioners（GPs） human resource and its gap with govern： merit＇ s 2020 policy goals. Methods： 2013--2016 national and provincial data from China health statistics yearbook were analyzed. The resource and consistent ratio per capita were applied to analyze the allocation of GP resources in institutions, regions and provinces. The registration ratio was used to calculate the profession attraction of GP. Pearson correlation coefficient was used to reflect the relationship between GPs allocation and related factors. Results： （1） Compared to 2012, the total number of trained GPs in 2015 was in＇ creased by 71.82%, while the registration rate of trained GPs had been below 40.00%. The registered GPs accounted by 2.20% of practicing（assistant） physicians. （2） The number of trained GPs and registered GPs per 10 000 residents were 1.37 and 0.50, The gap between east and middle-west areas was 1.7 times, and that between highest and lowest-allocated provinces was 7.8 times. The regis＇ tration rate of GPs in highest province was 3.9 times of that in the lowest. （3） 83.40% of trained GPs were in primary medical institutions. The average number of GPs per rural and urban basic institution were above 1 in 2012 and above 2 in 2014. The 2020 policy goal was completed ahead of time. （4）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 1 000 persons（r=0.64, 0.69, 0.60, 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 107 422 -229 528 person between present trained GPs and the 2020 goat of government＇s plan. According the low level of the plan, 11 provinces had a gap of trained GPs above 5 000, while 19 provinces did according the high level of the plan. Conclusion： The development of China s GPs human resource was confronted with lack of trained GPs, uneven distribution of human resource across the country and low registration rate, which demonstrated the tardy transformation of medical production, lack of incentive for GPs and the poor attractiveness of GPs＇ profession.
出处
《中国卫生经济》
北大核心
2017年第10期51-55,共5页
Chinese Health Economics
基金
国家自然科学基金项目(71373182)
关键词
全科医生
注册率
卫生资源配置
政策目标
general practitioners
registration rate
recourse allocation
policy goal
