社区中医“治未病”人才队伍现况及对策分析

Status of the Talents Team of TCM "Preventive Treatment of Disease" and Countermeasures

目的了解社区中医＂治未病＂人才队伍现况,并探讨其对策建议。方法选取2014年12月—2015年1月上海市黄浦区10个社区卫生服务机构的医务人员430名进行社会人口学特征调查。结果共发放问卷430份,回收有效问卷为403份,有效回收率为93.7%。社区医务人员中男女性别比为1∶2.3（121/282）,中西医岗位医生比为1∶3.8（78/296）,月收入2 000-7 999元占95.6%（385/403）。不同年龄、学历的社区医务人员性别分布间差异均有统计学意义（P〈0.05）;其中各年龄段女性所占比例均高于男性。不同性别、职称、职业的社区医务人员年龄分布间差异均有统计学意义（P〈0.05）;其中公共卫生（29.5%,18/61）、中医全科（18.2%,12/66）及中西医结合（16.7%,2/12）人员中20-岁所占比例较高,西医全科（51.0%,98/192）和中医全科（45.4%,30/66）人员中30-岁所占比例位居前两位,中西医结合（33.3%,4/12）及公共卫生（24.6%,15/61）人员中40-岁所占比例较高,中西医结合（41.7%,5/12）及西医其他（40.7%,22/54）人员中50-岁所占比例较高。不同性别、年龄、岗位的社区医务人员学历分布间差异均有统计学意义（P〈0.05）;其中西医岗位人员中本科学历所占比例较高（66.6%,197/296）,中医岗位人员中硕士及以上学历所占比例较高（16.7%,13/78）。不同年龄、学历、岗位、职称、月收入的社区医务人员婚姻状况分布间差异均有统计学意义（P〈0.05）;其中月收入2 000-元人员中未婚（21.8%,12/55）、离异及其他（5.5%,3/55）所占比例较高,6 000-元人员中初婚所占比例最高（91.0%,81/89）。不同年龄、职称、婚姻状况的社区医务人员月收入分布间差异均有统计学意义（P〈0.05）。不同学历、职称、职业类别、婚姻状况的社区医务人员岗位分布间差异均有统计学意义（P〈0.05）;其中高中及以下学历人员中西医岗位所占比例最高（88.2%,15/17）,硕士及以上学历人员中中医岗位所占比例最高（68.4%,13/19）。不同年龄、岗位的社区医务人员职称分布间差异均有统计学意义（P〈0.05）;其中20-岁人员中初级职称所占比例最高（84.8%,39/46）,40-岁（17.0%,15/88）、50-岁（11.2%,10/89）人员中高级职称所占比例较高。不同性别的社区医务人员工作年限分布间差异均有统计学意义（P〈0.05）;其中女性人员中工作年限1-5年所占比例较高（52.2%,36/69）,而男性人员中工作年限≥6年所比例较高（82.1%,23/28）。不同年龄、职业类别、工作年限、婚姻状况的社区医务人员认为＂治未病＂人才是否称职分布间差异均有统计学意义（P〈0.05）;其中中医全科人员中认为称职所占比例最高（68.2%,45/66）,中西医结合人员中认为不称职所占比例最高（58.3%,7/12）。结论各类别人力资源配备比例还没有达到理想状况,需进行结构和层次的调整。在开展社区中医药岗位培训时,男性、中年人员、专科学历者、中西医结合人员及西医人员是主要培训对象,应采取不同的政策、方式、手段,切实提高社区＂治未病＂人才队伍的服务水平。

Objective To investigate the talents team of TCM ＂preventive treatment of disease＂ communities,and put forward suggestions correspondingly.Methods From December 2014 to January 2015,we conducted survey of socialdemographic characteristics on 430 health workers from 10 community health service settings in Huangpu District in Shanghai.Results A total of 430 questionnaire were distributed,and 403 effective questionnaires were collected with an effective recovery rate of 93.7%.The male- femaile ratio was 1 ∶ 2.3（ 121 /282）,and the ratio between TCM posts to western medicine posts was 1∶ 3.8（ 78 /296）,and the range of monthly income was 2 000 - 7 999 yuan,accounting for 95.6%（ 385/403）.The subjects with different age and education background were significantly different in gender distribution（ P〈0.05）;of each age range,the proportion of females was higher than that of males.Community health workers of different gender,professional title and occupation were significantly different in age distribution（ P〈0.05）; the porprotions of health workers aged20 - was higher in the fields of western general practice（ 29.5%,18 /61）,TCM general practice（ 18.2%,12 /66） and combination of TCM and western medicine（ 16.7%,2 /12）; the fields of western general practice（ 51.0%,98 /192） and TCM general practice（ 45.4%,30 /66） had the first two highest proportions of health workers aged 30 -; the fields of combination of TCM and western medicine（ 33.3%,4 /12） and public health（ 24.6%,15 /61） had higher proportions of health workers aged 40 -; the fields of combination of TCM and western medicine（ 41.7%,5 /12） and other western medicine（ 40.7%,22 /54） had higher proportions of health workers aged 50 -.Communty health workers with different gender,age and post were significantly differently different in the distribution of education background（ P〈0.05）.The field of western medicine had higher proportion of health workers with bachelor degree（ 66.6%,197 /296）; the field of Chinese medicine had higher proportion of health workers with master＇s degree and above（ 16.7%,13 /78）.Community health workers with different age,education background,post,professional title and monthly income were significantly different in the distribution of marital status（ P〈0.05）; the proportions of being unmarried（ 21.8%,12 /55） and divorced（ 5.5%,3 /55） were higher among health workers earning 2 000 - yuan,and the proportion of being in first marriage was（ 91.0%,81 /89） highest among health workers earning 6 000 - yuan.Community health workers with different age,professional titles and marital status were significantly different in the distribution of monthly income（ P〈0.05）.Community health workers of different education background,professional titles,categories of occupation and marital status were significantly different in the distribution of post（ P〈0.05）;the proportion of western medicine posts was the highest among health workers with high school degree or below（ 88.2%,15 /17）; the proportion of TCM posts was the highest among health workers with master＇ s degree or above（ 68.4%,13 /19）.Community health workers with different age and posts were significantly different in the distribution of profession titles（ P〈0.05）; the proportion of primary professional title was highest among health workers aged 20 -（ 84.8%,39 /46）,and the proportion of senior professional title was higher among health worker aged 40 -（ 17.0%,15 /88） and 50 -（ 11.2%,10 /89）.Community health workers with different gender were significantly different in the distribution of years of working（ P〈0.05）; the proportion of 1 - 5 years of working was higher among female health workers（ 52.2%,36 /69）,and the proportion of ≥6 years of working was higher among male health workers（ 82.1%,23 /28）.Community health workers with different age,category of occupation,years of working,marital status were significantly different in recognizing the compentency of talents of TCM ＂ preventive treatment of disease＂ or not（ P〈0.05）; the proportion of recognizing their compentency was the highest among TCM general practitioners（ 68.2%,45 /66）,and the proportion of not recognizing their compenctecy was the highest among the combination of TCM and western medicine（ 58.3%,7 /12）.Conclusion The proportion of the equipment of human resources of each category is not ideal yet,which makes it necessary to make structural and hierarchical adjustment.In the training of community post of TCM,the main traning objects should be males,the middle aged,junior college graduates,health workers of the combination of TCM and western medicine and health workers of western medicine.Different policies,ways and means should be adopted to actually improve the service level of the talents team of TCM ＂ preventive treatment of disease＂.