中国眼科护理人力资源配置分析

Analysis of human resources allocation of ophthalmic nurses in China

目的描述我国眼科护士资源配置现状,并按可得性分级比较不同地区间的差异,有针对性地提出政策建议。方法使用最新《2015 年全国眼科能力资源调查表》和《中国人口和就业统计年鉴》数据,描述性分析我国眼科护士在不同地区间的数量、学历和职称情况,以人口加权四分位数法进行可得性分级,并进一步分析各地区及不同可得性级别的学历和职称结构。结果截止2014 年底,全国每10 万人眼科护士数为3.19 人,东部是西部的1.30 倍,城市是农村的3.85 倍。全国眼科医护比为1∶1.13,东部地区最低。眼科护士以大专学历及初级职称为主。东中西部地区整体可得性逐步递减,城市可得性均优于农村。可得性级别越高的地区,其本科及以上眼科护士占比也越高,而中高级职称眼科护士占比越低。可得性级别相同的情况下,西部和农村地区眼科护理人力资源质量最差。结论全国眼科护士资源配置逐渐改善,但仍存在区域不均、城乡差距大等问题;可得性分析可更细致地展现出区域间眼科护士数量差异,城乡处于极端分化状态;我国眼科护士整体质量有待进一步提高,质量差异将进一步加剧资源配置不均衡性。

Objectives To describe the human resource allocation of ophthalmic nurses in China, and to compare the differences based on the ophthalmic nurse availability among different regions so as to put forward policy recommendations. Methods We used the latest data of China Ophthalmic Competency Resource Survey in 2015 and China Population and Employment Statistics Yearbook to describe the quantity, education backgrounds and professional titles of ophthalmology nurses in different regions of China. Population-weighted quartiles of the county-level number were defined and used to analyze the differences in education backgrounds and professional titles among different regions and different levels of availability. Results By the end of 2014,the number of ophthalmic nurses was 3.19 per 100 000. The eastern part had 30% more nurses than the western and the urban area had 285% more than the rural area. The ratio of ophthalmology doctors to ophthalmic nurses is 1∶1.13 while the eastern area had the lowest ratio. Most of the ophthalmic nurses held post-secondary diploma and only entry-level titles. The availability of ophthalmic nurses in the east China was better than any other parts. It was easier to get an ophthalmic nurse in the cities than in rural areas. And the condition got worst in western rural districts. The proportion of nurses with a bachelor's degree went higher with the increase in availability, while this trend reverted with regard to the proportion of senior titled nurses. With the same availability, the quality of human resources in western and rural areas is the worst. Conclusions The resource allocation of ophthalmic nurses in China has gradually improved, but there are still problems such as regional inequality and large urban-rural gap. The availability analysis can show the inter-regional difference in terms of the quantity of ophthalmic nurses in a more detailed manner, such that the situations in the urban and rural areas are in extremely differentiated states;The quality of ophthalmic nurses in China needs to be further improved, and the quality difference will further aggravate the imbalance of resource allocation.