2010-2021年我国中医类执业(助理)医师数量结构及工作负担变化趋势分析

Analysis of the changing trend in the number structure and workload of traditional Chinese medicine practicing physicians(assistants)in China from 2010 to 2021

目的分析我国中医类执业(助理)医师的数量及工作负担长期变化趋势,为进一步优化我国中医类医师资源配置与相关政策制定提供参考。方法根据国家统计局和历年《中国卫生健康统计年鉴》相关数据,采用描述分析法分析我国2010—2021年中医类执业(助理)医师数量变化及工作负担情况。结果2010—2021年,我国中医执业(助理)医师数量由29.4万人增长到73.2万人,年均增长率为8.6%,高于执业(助理)医师5.4%的年均增长率;2021年,每千人口中医类执业(助理)医师数为0.52人,较2010年增加0.30人,年均增长率为8.1%,远高于同期每千人口执业(助理)医师数4.9%的年均增长率;中医类执业(助理)医师5年以下和30年及以上的占比分别为20.0%和21.4%均高于执业(助理)医师的占比(16.9%和20.1%);研究生及大学本科的占比合计为56.8%,低于执业(助理)医师此指标的占比(60.8%)4.0%;高级职称占比为16.6%,低于执业(助理)医师(20.4%)3.8%;中医类相关工作量均整体提升,但总诊疗量及增幅低于规划预期目标;中医医院医师日均担负诊疗人次数下降,且低于医疗机构医师平均水平。结论我国中医类执业(助理)医师数量总体稳步增长,达到并超越预期目标,中医药医疗服务供给能力进一步增强,但区域间配置不均衡;人才结构有待进一步优化,应注重中医人才培养及发展;工作量均整体提升,但总诊疗量及增幅低于规划预期目标;医师日均负荷下降,且低于医疗机构医师日均负荷的平均水平。

Objective To analyze the long-term changing trends in the number and workload of traditional Chinese medicine practicing physicians(assistants)in China,to provide a reference for further optimizing the resource allocation and related policy formulation of traditional Chinese medicine practicing physicians.Methods Based on relevant data from the National Bureau of Statistics and the China Health Yearbook over the years,descriptive analysis was used to analyze the changes in the number and workload of traditional Chinese medicine practicing physicians(assistants)in China from 2010 to 2021.Results From 2010 to 2021,the number of traditional Chinese medicine practicing physicians(assistants)in China increased from 294000 to 732000,with an average annual growth rate of 8.6%,higher than 5.4%for practicing physicians(assistants).In 2021,the number of traditional Chinese medicine practicing physicians(assistants)per thousand population was 0.52,an increase of 0.30 compared to 2010,with an average annual growth rate of 8.1%,much higher than 4.9%of practicing physicians(assistants)per thousand population during the same period.The proportion of traditional Chinese medicine practicing physicians(assistants)with less than 5 years and 30 years or more of work experience was 20.0%and 21.4%,respectively,which were higher than 16.9%and 20.1%of practicing physicians(assistants),respectively.The total proportion of graduate and undergraduate students was 56.8%,4.0%lower than the proportion of practicing physicians(assistants)(60.8%).The proportion of senior professional titles was 16.6%,3.8%lower than the proportion of practicing physicians(assistants)(20.4%).The workload related to traditional Chinese medicine had increased overall,but the total diagnosis and treatment volume and amplification were lower than the planned expected goals.The daily average workload of patient visits of physicians in traditional Chinese medicine hospitals had decreased,lower than the average level of physicians in medical institutions.Conclusion The overall number of traditional Chinese medicine practicing physicians(assistants)in China has steadily increased,reaching and exceeding expected goals.The supply capacity of traditional Chinese medicine medical services has further strengthened,but the allocation between regions is uneven.The talent structure needs further optimization,and attention should be paid to the cultivation and development of traditional Chinese medicine talents.The overall workload has increased,but the total diagnosis and treatment volume and amplification are lower than the planned expected goals.The daily average workload of physicians has decreased and is lower than the average level of daily load of physicians in medical institutions.