上海市郊区县社区医生配置结构比较分析

Comparison Analysis of Structure and Allocation of Community Physicians in Shanghai Counties

目的了解上海市郊区县社区医生结构配置差异。方法使用自行设计的调查表,对上海市9个郊区县的所有社区卫生服务中心进行普查,调查截至2014年5月的社区医生配置情况,并采用描述性统计、统计检验及线图进行资料分析。结果上海市郊区县共有社区医生7 856名,郊区县每千常住人口社区医生数为0.41人,其中崇明县最高,宝山区最低。上海市郊区县每平方公里社区医生数为1.19人,其中闵行区最高,崇明县最低。9个郊区县社区医生在学历和职称分布上均存在差异(P<0.01)。结论建议从以下三方面入手进一步加强扶持郊区县的社区医生发展:一是从医保支付方式改革入手,全面提升社区医生待遇。二是要突破人事编制等体制机制限制,鼓励医生下沉郊区社区。三是对郊区县社区医生实行专项优惠政策,稳定优化队伍。

OBJECTIVE To understand the allocation differences of community physicians among Shanghai counties. METHODS Using self-designed questionnaire to investigate all the community health services centers in 9 counties in Shanghai and grasp the picture of allocation condition of community physicians by then end of May, 2014. The data would be analyzed by descriptive statistics, statis- tical test and graph. RESULTS There were 7 856 community physicians in Shanghai counties, 0.41 community physicians per thou- sand permanent population with the highest of Chongming and lowest of Baoshan, 1.19 per sq.km with the highest of Minghang and lowest of Chongming. There were statistical differences of education and technical title of community physicians among Shanghai coun- ties （P〈0.01）. CONCLUSION It is suggested to enhance the development of community physicians in 3 aspects. One is to reform the health insurance payment way to overall improve the treatment. Another is to breakthrough the limitation of personnel system and mechanism to encourage more physicians into communities of counties. The other is to give special preferential policies to community physicians in counties to stabilize and optimize the team.