摘要
目的了解公共卫生医师职业基本情况,探究岗位职能、主要障碍及其原因。方法围绕近年来公共卫生医师数据,通过内容分析法对62份转录文稿进行定性、定量分析。结果自2003年以来公共卫生医师数量呈下降趋势,2016年我国公共卫生执业医师共计8.9万人,在四大执业医师中所占比例从2002年的8.2%下降到2016年的3.4%。2016年疾控中心公共卫生医师共计46 078人,占各机构公共卫生医师总量的51.9%。疾控中心2016年本科及以上学历者23 131,占50.2%;副高及以上职称者6 681,占14.5%;≥30年工作经历者15 390人,占33.4%。结合新形势要求,公共卫生职能应分为疾病预防控制、健康促进、健康影响因素监测、全科公共卫生、预防医学科公共卫生五大类。社会定位与处方权缺失、质量有待提高、供需矛盾严峻是公共卫生医师发展存在的主要问题。结论建议明确公共卫生医师职业标准与岗位胜任力,赋予处方权,探索公共卫生总师与基层全科公共卫生专岗。
Objective To examine basic situation and job responsibilities of public health physicians(PHPs) and to explore major obstacles to the improvement of the PHPs system in China. Methods We collected previous data relevant to the implementation of PHPs system from Statistics and Information Center of National Health and Family Planning Commission and China Health Statistics Yearbook for quantitative analysis;we also conducted a semi-structured interview among 52 randomly selected PHPs and a focus group discussion in 10 experts for qualitative analysis in 2017. Results The number of PHPs presented a downward trend from 2003. In China, the total number of certified PHPs was 89 000 in 2016.Among the four categories of medical practitioners, the proportion of PHPs declined from 8.2% in 2002 to 3.4% in 2016.There were 46 078 PHPs working in centers for disease control and prevention(CDCs) at various administration levels in2016, accounting for 51.9% of total number of PHPs in all medical institutions across China. Among all the PHPs in CDCs,50.2%(23 131) had education of undergraduate and above;14.5%(6 681) had vice senior professional titles;and 33.4%(15 390) had the professional working experience of 30 years or more. Based on the results of content analysis, the job responsibilities for all the PHPs covered following five categories: disease prevention and control, health promotion, health risk factor surveillance, general public health practice, and preventive medicine. The major problems for the improvement of PHPs system included the lack of social positioning and information prescription right, relatively lower professional capability of PHPs, and the gap between the requirement and existing number of PHPs. Conclusion The professional qualification and post competency of public health physicians should be ascertained clearly;the information prescription right should be entrusted to public health physicians;and the establishment of profession title for chief public health physician and general public health practitioner should be explored in China.
作者
龙成旭
唐尚锋
冯达
周葭蔚
付航
李刚
王若溪
冯占春
LONG Cheng-xu;TANG Shang-feng;FENG Da(School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030, China)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2019年第8期937-940,共4页
Chinese Journal of Public Health
基金
国家自然科学基金(71673098)
国家卫生健康委员会项目“公共卫生医师制度建设研究”
关键词
公共卫生
卫生人力
发展
职能建设
public health
health care manpower
development
function construction
