城市社区全科医生团队各岗位人员配置需求测算分析

Measurement and analysis of staffing standards of family doctor interdisciplinary team

目的利用世界卫生组织提出的工作负荷法，测算全科医生团队各岗位人员配置需求，为各地科学组建全科医生团队提供决策参考。方法采集全国16个省（区）150家样本社区卫生服务中心相关数据，按照工作负荷理论，测算样本中心平均每名全科医生服务人口数以及全科医生团队中医生、护士（防保人员）配置人数等。结果样本中心现有卫生技术人员10721人，2013年提供的服务总量为13214万个标准当量值。在保证服务质量和不加班的情况下，需要卫生技术人员数为19616人；平均每名全科医生服务1558名居民；全科医生团队中，平均1名全科医生需配备1．3～1．5名护士（防保人员），不同地区差异较大。结论目前城市社区卫生技术人员配置不足，缺口较大。我国提出的“每名全科医生的签约服务人数控制在2000人左右”的目标超出了全科医生团队的服务能力。建议各地适当下调团队服务的目标要求，逐步加大全科医生团队中护士的配置，以缓解全科医生配置难的局面。

Objective To measure and analyze the staffing standards of family doctor interdisciplinary team by means of the WHO workload indicator of staffing need （WISN）method, for reference of the government in building family doctor interdisciplinary teams. Methods 150 community health centers in 16 provinces were selected. The related data from 150 centers were collected to analyze the population served by each family doctor, and the staffing standards of family doctor interdisciplinary team by means of the WHO workload indicator of staffing need（WISN）method. Results There were 10 721 community health professionals in the sample centers which provide 132.14 million standard equivalents of service to the public. 19 616 community health professionals were needed to ensure the quality of service and no extra workload after work for professionals. Averagely, each family doctor can serve 1 558 residents,who needs 1.3~1.5 nurses or public health workers. Conclusions A huge gap was found for community health professionals. The population served by each family doctor should be lowered compared to the governmental requirement and more nurses should be introduced to the family doctor interdisciplinary team.