新医改下我国医院执业(助理)医师分布特征分析

Distribution Characteristics Analysis of Chinese Practicing(Assistant) Physicians in Hospitals under the Background of New Health Care Reform

目的:分析2002~2015年我国医院执业(助理)医师的配置结构及新医改前后变化趋势,为卫生人力资源相关政策的调整和制定提供数据支持。方法:通过查阅2003~2016年中国卫生(和计划生育)统计年鉴、2002~2015年我国卫生(和计划生育)事业发展统计公报和2014年、2016年中国统计年鉴收集相关数据,并进行描述性统计分析和比较分析。结果:与新医改前相比,新医改后我国医院执业(助理)医师在年龄、工作年限、学历和专业技术职务等方面的配置结构不断优化,每千人执业(助理)医师数持续增加,医护比不断下降,地域分布公平性也有所改善。但是,目前我国医院执业(助理)医师配置结构仍存在高学历人才分布不均、高中初级专业技术职务人数比例不合理、每床位执业(助理)医师数下降,医护比离目标值仍有较大差距,东中西部间医师分布和城乡间医师分布公平性仍待改进等问题。结论:加强执业(助理)医师队伍建设是新医改的重要任务之一,良好的执业(助理)医师队伍结构对深化医改意义重大。各级相关部门应加强政策引导,采用科学方法制定医师配置规划和配置标准,促进执业(助理)医师各项配置结构不断优化。

Objective To analyze the distribution structure of practicing （assistant） physicians in China during 2002 - 2015 and the trend of change between before and after the new health care reform, in order to provide data support for the adjustment and formulation of relevant policies on health human resources. Methods By checking the statistical yearbooks of national health （ and family planning） from 2003 to 2016, the statistical bulletins of national health （ and family planning） development from 2002 to 2015 and the China statistical yearbook 2014 and 2016 to carry out descriptive statistical analysis and comparative analysis. Results Compared with that before the new health care reform, the distribution of practicing （assistant） physicians in hospitals had been optimized in terms of age, working life, education background and professional post＇after the new health care reform in China. The number of practicing （assistant） physicians per thousand people continued to increase, the proportion of physicians and nurses declined, and the geographical distribution fairness had also been improved. However, there were still an uneven distribution of highly educated physicians and an unreasonable proportion among senior, medium and junior grade professional posts of practicing （assistant） physicians in hospitals. The number of practicing （assistant） physicians per bed declined, the gap between the proportion of physicians and nurses and the objective value was still large, the distribution of practicing （assistant） physicians among the eastern, central and western regions and the distribution between urban and rural areas were still unfair. Conclusion Strengthen the construction of the practicing （assistant） physician team is one of the important tasks of the new health care reform. Relevant departments should step up policy guidance and adopt scientific methods to formulate physician configuration planning and standards to promote continuous optimization of practicing （assistant） physicians＇ distribution structures.