2013年至2017年北京市儿科医疗资源配置现状分析

Analysis of current situation of pediatric medical resources allocation in Beijing from 2013 to 2017

目的了解北京市儿科医师配置现状及诊疗负担情况,为有效配置儿科医师提供依据。方法选取北京市卫生综合统计信息平台的《北京市卫生机构人力基本信息调查表》《医疗卫生机构年报表》《北京市卫生工作统计资料(简编)》《北京市卫生和计划生育统计年鉴》中的相关数据指标,对2013年至2017年的儿科医师数、每千儿童医师数、每儿科医师负担门急诊人次数、每儿科医师负担出院人数等指标进行动态分析。对相关数据进行描述性分析。结果2017年,北京市儿科医师数占全市医师数的2.78%,儿科门急诊量占全市总门急诊量的6.47%,住院量占全市总量的5.70%;2013年至2017年,每儿科医师负担门急诊人次数增长40.58%,负担出院人数增长36.70%。三级医院住院量占比由80.2%增加至85.1%,基层机构占比由6.3%下降为1.7%。结论北京市儿科医疗资源配置存在总量不足、分配不合理、儿科医师诊疗负担过重等问题。应加强儿科人力资源的规划建设,完善儿科医师培养模式,提高儿科医师的薪酬水平,缓解儿科医师负担,以便为儿童提供优质的医疗服务。

Objective To find out the present pediatrician allocation and the burden of diagnosis and treatment in Beijing, so as to provide evidence for effective allocation of pediatricians. Methods Data and indicators were selected from Beijing Health Comprehensive Statistical Information Platform, including Manpower Basic Information Survey of Beijing Health Institutions, Annual Report of Medical Institutions, Beijing Statistical Data on Health Work(Compendium), as well as Beijing Health and Family Planning Statistical Yearbook. The study dynamically analyzed the number of pediatricians, that of pediatricians per 1 000 children, that of outpatients and emergency patients per pediatrician and the number of discharges per pediatrician from 2013 to 2017. Descriptive analysis was carried out on the data. Results In 2017, the proportion of pediatricians accounted for 2.78% of the total number of doctors in the city, the number of pediatric emergencies accounted for 6.47% of the total outpatients and emergencies in the city, and the number of hospitalizations accounted for 5.70% of the total discharge in the city.From 2013 to 2017, the number of outpatients and emergency patients per pediatrician increased by 40.58%, and the number of discharged patients increased by 36.70%. The proportion of hospitalization at tertiary hospitals increased from 80.2% to 85.1%, and that in primary institutions decreased from 6.3% to 1.7%. Conclusions The study found such setbacks in the allocation of pediatric medical resources in Beijing, as insufficient pediatricians, unreasonable allocation and excessive burden on pediatricians. We should strengthen the planning and construction of pediatric human resources, improve the training mode of pediatricians, improve the salary level of pediatricians, and ease the burden on pediatricians, so as to provide high-quality medical services for children.