新医改背景下北京乡镇卫生机构人力资源配置分析

Analysis on Health Personnel Arrangement in Township Hospitals in Beijing City During Health Care Reform Period

目的了解新医改背景下北京远郊区县基层卫生人力的配置状况,探讨人力建设面临的主要问题及机遇,为农村卫生人力发展提供实证依据和政策建议。方法收集北京市3个远郊区县近两年卫生人力的监测信息,对关键人物进行个人深入访谈。结果 2009年调查地区乡镇卫生机构卫技人员数共2 709人;每千服务人口卫技人员1.01人,低于2008年(1.38),也低于全国农村平均水平(1.28)。从人员结构来看,医护比为1∶0.5;55岁及以上人员所占比例从2008年的19.75%下降到2009年的4.98%;卫技人员学历仍以大专及以下为主,其中中专及以下人员占到卫技人员的36.00%。结论北京市远郊区县乡镇卫生机构卫技人员总量不足;人员队伍开始有年轻化发展的趋势;人员结构中存在医护比例倒置和学历偏低的问题。政府需要根据当地人群需求合理配置专业人员,并形成稳定可持续的人才培养机制。

Objectives To better understand medical human resource allocation in Suburb Beijing in order to identify main problems and give evidence-based policy recommendations for planning future human resource blueprint. Methods Routine data from health department in three counties was collected.In-depth interviews were applied to key stakeholders in these three counties. Results There were totally 2 709 health specialists working in township hospitals in 2009,which equaled to 1.01 staff per thousand rural population.This is below ratio of 1.38 for 2008 and is lower than national average ratio of 1.22 for rural China as well.Moreover the ratio of doctors to nurses is 1:0.5.The percentage of health specialist aged 55 and above is dropping from 19.75% in 2008 to 4.98% in 2009.The majority of health specialists holds college diplomas or below.In particular,36% of health specialists have only certificates from technical secondary schools. Conclusions There is apparently health human resource shortage in suburb Beijing.And health specialists tend to be younger compared to the past.The percentage of nurses among health specialists is markedly low,while education level of health specialists is also relatively low.Therefore local government should allocate qualified health specialists according to residents' demand,and form a stable and sustainable training mechanism of health human resource in Suburb Beijing.