新医改背景下县级医疗机构人力资源与服务效率变化趋势分析

Analysis of the Trend of Human Resources and Efficiency of Health Services at Countylevel Hospitals in the Context of the New Round of Health Reform

目的分析新医改背景下青海省县级医疗机构人力资源与服务效率的变化趋势,挖掘其存在的问题并提出政策建议。方法收集青海5所县级医院2009—2012年人力资源和卫生服务效率数据,采用描述性分析进行评价。结果样本医院卫生技术人员所占比例均值4年波动在82.83%~88.53%之间,每床位职工总数均值4年波动在0.87~1.01之间,均呈下降趋势;每床位卫技人员数均值4年最高为0.89。4年间平均住院日略有下降,床位利用率、每卫技人员日均诊疗人次和每日负担病床日均有不同程度的上升。结论医改政策的实施仍未能有效解决青海县级医院的人才短缺问题,但在一定程度上提升和改善了县级医疗机构的卫生服务效率。高素质的基层人力资源不足是困扰县级医院医疗服务整体能力进一步提升的关键制约因素。

Objectives To analyze the trends of human resources and efficiency of health services in health institu- tions at county level of Qinghai province in the context of the new round of health reform,and to dig the problems and put forward policy recommendations for improvement. Methods Data of human resources and efficiency of health services of 2009 to 2012 in 5 county-level hospitals were collected in Qinghai province,and were evaluated by use descriptive analysis method. Results Health technical personnel proportion of the sampled hospitals＇ staff was between 82.83% and 88.53% in the four years,while the average level of the ratio of the number of hospital staff to the number of bed was between 0.87 and 1.01 ,and they both had a downward trend. The average ratio of the number of health technical personnel to the number of bed was no higher than 0.89 in the four years. The average days of hospitalization shower a downward trend,while the availability of bed and the number of outpatient visits per health technical personnel per day and the number of days of beds per health technical personnel per day showed an upward trend in the four years. Conclusions The health service efficiency of county-level hospitals have been improved in different degrees during the context of the new round of health reform, while the talent shortage of county-level hospitals in Qinghai province haven not been resolved efficiently. The lack of high quality human resources in grass-roots level is the key factors restricting the further improvement of the overall ability of medical service in the county-level hospitals.