Objective Allocation of human resources to address inequalities in the public health system has increasingly attracted societal and political attention.Using the Centers for Disease Control and Prevention(CDCs)system ...Objective Allocation of human resources to address inequalities in the public health system has increasingly attracted societal and political attention.Using the Centers for Disease Control and Prevention(CDCs)system of China as an example,we evaluated inequality in the public health workforce distribution across different regions in China between 2008 and 2017,with the aim of providing information for policymakers to support resource allocation and address growing health inequities.Methods We used three standard public health workforce inequality indices-Gini coefficient,Theil L,and Theil T-and spatial autocorrelation analysis to explore spatial clusters of the workforce in different provinces,visualized with geographical tools.Results The aggregate workforce-to-population ratio decreased from 1.47 to 1.42 per 10,000 population from 2008 to 2017,and was consistently lower than the National Health Commission’s(NHC)recommended critical shortage threshold of 1.75.The workforce distribution inequality indices varied by regional socioeconomic and health system development.Geographic clustering of CDCs workforce distribution was evident,with H–H and L–L clusters in western China and the Guangdong-Fujian region,respectively.Conclusions Our study addressed key issues for government and policymakers in allocation of public health human resources.There is an urgent need for careful identification of analytic questions that will help carry out public health functions in the new era,alongside policy implications for an equitable distribution of the public health workforce focusing on the western region and low–low cluster areas.展开更多
We aimed to describe the distribution of tuberculosis （TB） health workers in China and provide evidences of potential inequity for policy development. We used Lorenz curves and Gini index to characterize the distrib...We aimed to describe the distribution of tuberculosis （TB） health workers in China and provide evidences of potential inequity for policy development. We used Lorenz curves and Gini index to characterize the distribution of TB health workers by population size, geographical area and number of annual registered TB cases. An additional stratified analysis was done by three economic regions. The Gini index were 0.33 for population size, 0.62 for geographical area and 0.30 for number of registered tuberculosis cases that indicated an acceptable average, significant inequity and a relative average distribution nationwide respectively.展开更多
Gender differences in the health workforce matter for women’s health and healthcare,and is also crucial for both health and economic development.Drawing on limited national gender data from China over the last 10 yea...Gender differences in the health workforce matter for women’s health and healthcare,and is also crucial for both health and economic development.Drawing on limited national gender data from China over the last 10 years,during which the country was undergoing a healthcare reform,this study dissects gender-related issues to identify existing problems,monitor progress,and develop strategies to promote change.Although women constituted the majority of health workers,they are predominantly engaged in service-oriented occupations.The gender distribution substantially differed between urban and rural primary health institutions.Moreover,significant differences in gender distribution among professional public health institutions were observed.The gender distribution of administrators varied in different types of health institutions.Women had lighter workloads because of the imbalanced distribution of specialties.Academicians comprised very few female scientists.To promote a more balanced gender distribution,policies should be developed to encourage a more reasonable division of family responsibilities.Further,equal higher education opportunities should be ensured for girls,especially in rural areas.Solutions to free more women from work-marriage-childcare conflicts and to decrease turnover rates deserve further discussion.Gender data should be highlighted and optimized to further advance gender differences among the health workforce and for women’s health in China.展开更多
Purpose:To examine variations in Chinese nurses’Actual Scope of Practice(ASCOP)by educational qualifications and professional titles,and to identify regulatory gaps in competency-based role assignments within China’...Purpose:To examine variations in Chinese nurses’Actual Scope of Practice(ASCOP)by educational qualifications and professional titles,and to identify regulatory gaps in competency-based role assignments within China’s evolving healthcare system.Method:A nationwide cross-sectional study using the validated Chinese Nurses’ASCOP Questionnaire is used.Data from 1,540 nurses were analyzed through descriptive statistics,independent t-tests,one-way ANOVA,and Bonferroni correction.ASCOP scores(1–5 scale)were compared across education levels(diploma,bachelor’s,postgraduate)and titles(junior/senior).Results:The overall ASCOP score was 3.95,with significant disparities in high-complexity tasks:postgraduate nurses(4.25)and senior nurses outperformed diploma holders(3.71)and juniors(p<0.01).Low-complexity tasks showed no educational differences(p>0.05),though bachelor’s or postgraduate nurses reported higher frequencies(4.12 vs.3.89).Alarmingly,37.6%of junior nurses routinely performed high-risk procedures beyond their competency.Conclusion:A systemic mismatch exists between nurses’qualifications and assigned responsibilities,reflecting inadequate regulatory oversight.To address this,this study recommends:(1)competency-based tiered authorization systems,(2)legal framework updates aligning with China’s healthcare reforms,and(3)dynamic monitoring mechanisms.These measures could standardize practice boundaries,mitigate occupational risks,and optimize nursing workforce utilization,particularly in resource-constrained settings.展开更多
基金funded by China CDC’s Public Health and Emergency Response Mechanism Programme[131031001000150001]。
文摘Objective Allocation of human resources to address inequalities in the public health system has increasingly attracted societal and political attention.Using the Centers for Disease Control and Prevention(CDCs)system of China as an example,we evaluated inequality in the public health workforce distribution across different regions in China between 2008 and 2017,with the aim of providing information for policymakers to support resource allocation and address growing health inequities.Methods We used three standard public health workforce inequality indices-Gini coefficient,Theil L,and Theil T-and spatial autocorrelation analysis to explore spatial clusters of the workforce in different provinces,visualized with geographical tools.Results The aggregate workforce-to-population ratio decreased from 1.47 to 1.42 per 10,000 population from 2008 to 2017,and was consistently lower than the National Health Commission’s(NHC)recommended critical shortage threshold of 1.75.The workforce distribution inequality indices varied by regional socioeconomic and health system development.Geographic clustering of CDCs workforce distribution was evident,with H–H and L–L clusters in western China and the Guangdong-Fujian region,respectively.Conclusions Our study addressed key issues for government and policymakers in allocation of public health human resources.There is an urgent need for careful identification of analytic questions that will help carry out public health functions in the new era,alongside policy implications for an equitable distribution of the public health workforce focusing on the western region and low–low cluster areas.
基金supported by Ministry of Health,China and the Swedish International Development Cooperation Agency granted project "Evidence for Policy and Implementation (EPI-4) Intensifying efforts to achieve the health-related MDGs in four countries with developing economies"
文摘We aimed to describe the distribution of tuberculosis （TB） health workers in China and provide evidences of potential inequity for policy development. We used Lorenz curves and Gini index to characterize the distribution of TB health workers by population size, geographical area and number of annual registered TB cases. An additional stratified analysis was done by three economic regions. The Gini index were 0.33 for population size, 0.62 for geographical area and 0.30 for number of registered tuberculosis cases that indicated an acceptable average, significant inequity and a relative average distribution nationwide respectively.
基金supported by the National Natural Science Foundation of China(72104140,82101870,81902939,and 72274209)Shanghai Pujiang Program(21PJC083)+3 种基金the Soft Science Project of Shanghai Science and Technology Innovation Action Plan(23692115000 and 23692113200)Zhejiang Provincial Natural Science Foundation(LQ21H100001)Hangzhou Health Science and Technology Program(B20220431)the Innovative Research Team of High-level Local Universities in Shanghai(SHSMU-ZLCX20211602).
文摘Gender differences in the health workforce matter for women’s health and healthcare,and is also crucial for both health and economic development.Drawing on limited national gender data from China over the last 10 years,during which the country was undergoing a healthcare reform,this study dissects gender-related issues to identify existing problems,monitor progress,and develop strategies to promote change.Although women constituted the majority of health workers,they are predominantly engaged in service-oriented occupations.The gender distribution substantially differed between urban and rural primary health institutions.Moreover,significant differences in gender distribution among professional public health institutions were observed.The gender distribution of administrators varied in different types of health institutions.Women had lighter workloads because of the imbalanced distribution of specialties.Academicians comprised very few female scientists.To promote a more balanced gender distribution,policies should be developed to encourage a more reasonable division of family responsibilities.Further,equal higher education opportunities should be ensured for girls,especially in rural areas.Solutions to free more women from work-marriage-childcare conflicts and to decrease turnover rates deserve further discussion.Gender data should be highlighted and optimized to further advance gender differences among the health workforce and for women’s health in China.
基金Central Universities Basic Research Fund(Science,Engineering,and Medicine)of Jinan University:“Development of a Nursing Work Time Tracking System Based on the Fourth-Generation Nursing Workload Theory”(Project No.:21619326)。
文摘Purpose:To examine variations in Chinese nurses’Actual Scope of Practice(ASCOP)by educational qualifications and professional titles,and to identify regulatory gaps in competency-based role assignments within China’s evolving healthcare system.Method:A nationwide cross-sectional study using the validated Chinese Nurses’ASCOP Questionnaire is used.Data from 1,540 nurses were analyzed through descriptive statistics,independent t-tests,one-way ANOVA,and Bonferroni correction.ASCOP scores(1–5 scale)were compared across education levels(diploma,bachelor’s,postgraduate)and titles(junior/senior).Results:The overall ASCOP score was 3.95,with significant disparities in high-complexity tasks:postgraduate nurses(4.25)and senior nurses outperformed diploma holders(3.71)and juniors(p<0.01).Low-complexity tasks showed no educational differences(p>0.05),though bachelor’s or postgraduate nurses reported higher frequencies(4.12 vs.3.89).Alarmingly,37.6%of junior nurses routinely performed high-risk procedures beyond their competency.Conclusion:A systemic mismatch exists between nurses’qualifications and assigned responsibilities,reflecting inadequate regulatory oversight.To address this,this study recommends:(1)competency-based tiered authorization systems,(2)legal framework updates aligning with China’s healthcare reforms,and(3)dynamic monitoring mechanisms.These measures could standardize practice boundaries,mitigate occupational risks,and optimize nursing workforce utilization,particularly in resource-constrained settings.
