湖南省县级医院儿科资源及儿科医师工作现状调查研究

Investigation and Research on Pediatric Resources and Working Status of Pediatricians of County-level Hospitals in Hunan Province

目的通过深入了解和分析湖南省县级医院儿科资源现状和儿科医师的执业情况与工作满意度,为完善区域儿科医疗体系和提高儿科卫生服务能力提供科学依据。方法于2017年5-6月采用普查法,将定量与定性调查相结合,采用统一设计的调查问卷,共调查湖南省境内90所县级医疗机构的482名儿科医师。通过描述性统计方法和综合评价,分析湖南省县级医院儿科医疗服务现状、医师人力资源现状和满意度情况。结果湖南省县级医院儿科门急诊及住院服务不足。儿科门诊人次约占门诊总人次的18.45%,儿科住院人次约占年住院总人次的16.90%,16.21%的机构儿科病房与其他科室共同使用。2011-2015年,儿科医师总数从684人增加到991人;年度流失数为24~43人;新招人数为74~90人,无明显增长趋势。儿科医师工作强度较大,工作满意度较低,超过60%的儿科医师感到"很不满意"或"不太满意"。结论湖南省县级医院儿科医疗服务资源不足,医师缺乏,工作满意度低。应通过完善儿科医疗体系建设,整合优质儿科医疗资源;健全儿科医师培养体系,强化儿科人才培养;重视儿科发展氛围,提高人员满意度等措施加强儿科建设,提高儿科医疗服务能力。

Objective To provide a scientific basis for improving the pediatric medical system and pediatric health service capacity in our province through in-depth understanding and systematic analysis of the status of pediatric resources in county hospitals in Hunan Province and the practice and paternity of pediatricians.Methods From May to June 2017,a census was conducted using a unified design questionnaire which can combine quantitative and qualitative investigations.A total of 482 pediatricians of 90 county-level medical institutions in Hunan Province were investigated.Through the descriptive statistical methods and comprehensive evaluation,the status quo of pediatric medical services,the status quo and satisfaction of physicians’ human resources in county hospitals in Hunan Province were analyzed.Results The pediatric hospital emergency department and inpatient services in county hospitals in Hunan Province were insufficient.Pediatric outpatients accounted for 18.45% of the total number of outpatients,and pedia-tric inpatients accounted for 16.90% of total annual hospitalizations.16.21% of institutional pediatric wards were shared together with other departments.In the past five years(2011-2015),the total number of pediatricians had increased from 684 to 991;the annual loss number was from 24 to 43;the number of new recruits was 74 to 90,with no obvious growth trend.Pediatricians had heavy work load and a low job satisfaction.More than 60% of pediatricians felt "very dissatisfied" or "not very satisfied".Conclusion Overall,the pediatric medical service resources of county-level hospitals in Hunan Province are insufficient,the number of physicians is shortage,and job satisfaction is low.We should improve the development of pediatric medical system,integrate high-quality pediatric medical resources,improve the pediatrician training system,strengthen pediatric talent training,attach importance to pediatric development atmosphere,improve staff satisfaction and other measures to strengthen pediatric construction and improve pediatric medical service capabilities.