摘要
目的:探讨在供给侧结构性改革背景下,2015年山东省8类社区卫生服务中心人力资源缺失状况及存在问题。方法:采用PPS抽样方法抽取东中西17个地市333家8类样本社区卫生服务中心,运用描述性研究指标对人力资源缺失现状进行分析评价。结果:8类333家社区卫生服务中心在岗19813人,在编12233人,无编制率38. 26%,空编率5. 71%,全员聘用率15. 62%,中高级职称占比32. 13%;医师6411人,占32. 13%,护士5177人,占25. 90%,医技药剂3035人,占15. 99%;卫生专业技术14910人,医疗、中医、妇幼和公共卫生人员配比为71. 60%、18. 65%和11. 79%;执业护士,占护士98. 45%,医护比为1. 26∶1;执业医师4890人,占医师75. 24%,执业助理医师1241人,占17. 86%;妇产、中医和全科医师占比为11. 43%、5. 95%和28. 33%,全科毕业237人,占10. 08%,规范化培训1274人,占72. 27%,转岗培训1088人,占57. 14%,东中西7类机构全科毕业配比为0. 00%。结论:各类社区卫生服务中心呈由东到西递减分布,西部人力资源配置优于东中部,大多数机构功能定位不明确,存在"资源错配与逆向流动"现象,两少(人员少、编制少)、四低(学历低、职称低、专业水平低、待遇低)问题严重,全科医师、妇幼保健、公共卫生等人员配置不足,主动流失率较高;需因地制宜,利用存量盘活、增量调节、适度引进和留住培养等手段矫正人员配置失衡。
Objective Under supply - side structural reform, to explore manpower shortage situations and problems of 8 kinds of community health centers in Shandong province in 2015, for offering scientific advices to expand effective supplies of health human resources. Methods PPS sampling method was used to extract data about 8 kinds of 333 community health centers in 17 east -central -west cities. Then, human resource deficit status was analyzed and evaluated by descriptive research indexes. Results Data showed that 8 kinds of 333 community health centers had 19813 employees and 12233 permanent staffs. Only 15.62% institutions put into full employment system. Among employees, some were uncompiled staffs, accounted for 38.26%, and others were not on duty, accounted for 5.71%. Medium and senior titles of position were accounted for 32. 13%. In on - post staffs, there were 6411 physicians, accounted for 32. 13%, 5177 nurses, accounted for 25.90%, 3035 medicinal technicians, accounted for 15.99%. Ratios of medical treatment, Chinese medicine and prevention were 71.60%, 18.65% and 11.79% in 14910 professional medical workers. In nurses, licensed practical nurses were accounted for 98.45%. Doctor and nurse ratios were 1.2 . In physicians, 4890 doctors had qualification certificates, accounted for 75.24%, and 1241 doctors had assistant qualification certifi- cations, accounted for 17. 86%. Ratios of obstetricians and gynecologists, herbalist doctors, and general practitioners were 11.43%, 5.95% and 28. 33%. Data showed 237 general practitioners were general graduates, accounted for 10. 08%, 1274 physicians participated in standardized trains, accounted for 72. 27% , and 1088 physicians attended position transition trains, accounted for 57. 14%. Meanwhile, seven kinds of institutions in east - central - west regions had no general medical graduates. Conclusions All types of community health service centers showed a regressive distribution from east to west. Among them, human resource allocation in the west was superior to eastern and central regions. Between resources, patients and costs, there was ＇ resources mismatch and reverse flow＇ phenomenon in most of community health service centers. More so, institutions had some problems such as unclear preventive function, less public health workers, general practitioners and MCH workers, unreasonable structure, high active turnover rates, and serious two less （less staffs, less preparations）and four tow（ low educations, low titles,low professional levels, low treatments）. Government should do best efforts to facilitate market orientation and adjust measures to local conditions. Of which, coordinating inventory resurrection with increment adjustment and combining appropriate introduction with remain training were necessary measures to correct personnel imbalance.
出处
《中国卫生事业管理》
北大核心
2018年第11期804-808,838,共6页
Chinese Health Service Management
基金
国家自然科学基金项目"中国不同地区基本医疗卫生制度实施效果评价与策略"(71273191)
"中国卫生总费用风险预警系统研究"(71673202)
"健康山东"重大社会风险预测与治理协同创新中心资助课题"山东农村基层公共卫生应急人力系统脆弱性评价与发展策略研究"(XT1407003)
"新农合基金支付风险预测与策略优化研究"(XT1401002)
山东省自然科学基金项目"公平与效率视角下新医改政策对卫生服务供需方式利益博弈机制影响的研究"(ZR2014GL012)
山东省自然科学基金面上项目"基本药物制度对村级卫生人员工作行为影响的前瞻性研究"(ZR2011GM005)
山东省高等学校人文社科计划项目"基本公共卫生服务均等化视角下城乡居民健康公平的社会决定因素与管理模式研究"(J17RA140)
山东省研究生导师指导能力提升项目(SDYY17104)
关键词
社区卫生服务中心
人力资源
人才短缺
community health service center
human resources
manpower shortage
