江苏省不同体制乡镇卫生院人力资源现况及需求调查

Status and demands of health human resource in public and private township health centers in Jiangsu province

目的了解2013年江苏省公办、民营乡镇卫生院人力资源及需求现况,为探讨乡镇卫生院"民营化"的合理途径和方法提供参考依据。方法结合江苏省信息中心2013年对全省13个市1 634家乡镇卫生院(公立卫生院1 282家,民营卫生院352家)的上报数据进行描述性分析。结果苏中、苏北地区民营乡镇卫生院≥55岁卫生技术人员构成比分别为14.9%和11.8%,均明显高于公办卫生院的7.8%和5.8%;苏南地区大专及以上第一学历者比例(34.7%),高于苏北(24.4%)和苏中地区(25.2%),且民营卫生院(43.5%)高于公办卫生院(34.3%);全省公办乡镇卫生院正、副高级卫生技术人员(3.8%)略多于民营卫生院(2.9%),而苏南民营卫生院(6.3%)高于公办卫生院(3.8%);苏南地区民营乡镇卫生院服务地区每万常住人口执业(及助理)医师、护士、药师配备人数分别为6.2、4.3、1.2人/万人,均高于公办卫生院的4.9、3.5、0.8人/万人;苏北、苏中地区则相反。结论乡镇卫生院卫生人力资源是否优质并不仅由卫生院的所有权性质决定,更与当地的经济发展水平及其背后隐藏的地方政府执政思路和能力密切相关。

Objective To examine the status and demands of health human resource in public and private township hospitals and to provide references for the privatization of township health centers （THCs） in Jiangsu province. Methods Totally 1 634 THCs （ 1 282 public and 352 private THCs） were included in the survey. Results The ratios of the medi- cal staff equal or older than 55 years were 14. 9% and 11.8% for the private THCs in central and northern region of the province and were higher than those for the public THCs in the same region（7.8% and 5.8% ）. The proportion of the medical staff with undergraduate or postgraduate education for the THCs in southern region was 34. 7 %, higher than those for the THCs in northern （24. 4% ）and central region（25.2% ）, and the proportion for private THCs was higher than that for public THCs（43.5% vs. 34. 3% ）. The average proportion of the medical personnel with senior or vice-senior techni- cal title was 3.8% for public THCs and higher than that for private THCs（2. 9% ）in the province;but compared to that for public THCs, the proportion was much lower for private THCs （ 3.8 % vs. 6. 3 % ） in southern region of the province. In the southern region, the numbers of physicians and physician assistants, registered nurses, and pharmacists in public THCs for every ten thousands residents of in south area were 6. 2,4. 3, and 1.2 and were higher than those in private THCs （4. 9,3.5, and 0. 8 ） ;while in northern and central region, the numbers were lower in public THCs compared to private THCs. Conclusion The quality of human resource for THCs depends not only on the ownership structure of the medical facilities,but also on local economic development level and management policy and capability of the government agencies.