我国村级卫生人力资源充足性研究

Study on Adequacy of Village Health Human Resources in China

目的分析新医改实施前后我国村级卫生人力资源变化情况,发现数量和质量方面存在的问题,为制定基层医疗卫生人力政策提供参考。方法利用村卫生人员数量、村医定基比和环比变化、村医相对数量、执业资格构成、村医学历构成等指标,分析医改前后村卫生室人员变化。结果近年来我国村级卫生人员有所增加,但占全国卫生员比重下降;2011年后乡村医生出现负增长,千农业人口及村均乡村医生配备不足;执业(助理)医师和注册护士数量不断增加,但比重不足26%;乡村医生以中专学历为主,大专学历不到5%。结论村卫生室缺乏吸引人才的长足动力;农村将面临村医(尤其是高学历村医)严重短缺问题;乡村医生向执业(助理)医师转化速度较慢。建议改善农村执业环境;提高村医收入水平,制定优惠政策引进人才;改进执业医师考试内容,提高村医报考积极性。

Objectives To analyze the changes of village health human resources before and after implementation of the new health care reform,then find the problem on quantity and quality,and provide references for the manpower policy of primary health care. Methods The paper analyzed the changes of village health workers before and after implementation of the new health care reform through index of village health workers quantity and proportion, professional qualification ratio, educational background ratio. Results The number of village health workers is increasing in recent years, but the proportion of village health workers account for total national health workers is declining. After 2011 ,the number of rural doctors is growing negatively,and the number of rural doctors per thousand agricultural population is declining as well as each village rural doctors. The number of practitioners（Assistant）and registered nurses is increasing, but less than 26%. Rural doctors were technical secondary school qualifications mostly, while people with college degree accounted less than 5%. Conclusions Health staffing shortages at the village has been improved, but village clinics lack the impetus to attract talents. Countryside will face serious shortage of rural doctors, especially highly-educated rural doctors. The transformation from rural doctors to practitioners（Assistant）is slowly. The study aims to improve the working environment in villages, promote the income level of rural doctors and formulate preferential policies to attract talents,improve the contents of practitioner exam and enhance the enthusiasm of rural doctors to apply for it.