2014—2018年我国全科医生资源配置均衡性研究

Equilibrium of general practitioner allocation in China from 2014 to 2018

目的分析2014—2018年我国全科医生资源配置现状并探讨其发展趋势及其公平性,最终为优化和调整我国全科医生资源配置提供参考依据。方法运用描述性分析法研究我国2014—2018年全科医生人才队伍的发展现状,运用集聚度方法探讨我国全科医生资源配置的公平性。结果2014—2018年我国全科医生及每万人口全科医生数分别增长136143名和0.95名。东、中、西部地区全科医生集聚度分别为4.9112~5.0048、1.2899~1.4279和0.2774~0.2976;全科医生集聚度与人口集聚度比值分别为1.3261~1.3535、0.7189~0.8004和0.7280~0.7842。截止2018年,我国31个省、自治区、直辖市中,全科医生总量居于前3位的地区分别是江苏(47794名)、广东(27638名)、浙江(26047名),居于后3位的地区分别为西藏(352名)、宁夏(1279名)、青海(1315名)。每万人口全科医生数居于前3位的地区分别为江苏(5.94名)、浙江(4.54名)、北京(4.11名),居于后3位的地区分别为西藏(1.02名)、江西(1.21名)、湖南(1.28名)。全科医生集聚度居于前3位的分别为上海(42.4741)、北京(16.8524)、江苏(13.9144),后3位的分别为西藏(0.0089)、青海(0.0570)、内蒙古(0.1291),全科医生集聚度与人口集聚度的比值居于前3位的为江苏(2.6852)、浙江(2.0537)、北京(1.8608),居于后3位的为西藏(0.4629)、江西(0.5469)、湖南(0.5797),比值最为接近1的3个省份为青海(0.9864)、河南(0.9653)、福建(0.9391)。结论我国全科医生发展态势总体趋好,但仍存在需求缺口。全科医生地区间资源配置不均衡,差异性较大,且区域间全科医生发展速度有所不同。全科医生注册率相对较低,因此,应大力推进我国全科医生培养制度建设,加强全科医生人才培养,不断提高注册率,同时合理规划各区域间全科医生资源布局,注重均衡性发展。

Objective To investigate general practitioner allocation in China from 2014 to 2018 and explore its development trend and equilibrium so as to provide references for optimizing and adjusting the allocation nationwide.Methods A descriptive analysis method was used to analyze the general practitioner allocation in China from 2014 to 2018,and the agglomeration method was used to discuss the equality and justice of it.Results From 2014 to 2018,the number of general practitioners and general practitioners per 10000 population in China increased by 136143 and 0.95,respectively.The concentration rates of general practitioners in the eastern,central and western regions were 4.9112-5.0048,1.2899-1.4279 and 0.2774-0.2976,respectively;The ratios of the concentration of general practitioners to the population concentration were 1.3261-1.3535,0.7189-0.8004 and 0.7280-0.7842,respectively in the three regions.As of 2018,among the 31 provinces,autonomous regions and municipalities in China's Mainland,the top three regions in view of number of general practitioners were Jiangsu(47794),Guangdong(27638),and Zhejiang(26047),and the three regions listed at the end were Tibet(352),Ningxia(1279),and Qinghai(1315).The top three regions for general practitioners per 10000 population were Jiangsu(5.94),Zhejiang(4.54)and Beijing(4.11),and the three listed at the end were Tibet(1.02),Jiangxi(1.21)and Hunan(1.28).The top three of the concentration rate were Shanghai(42.4741),Beijing(16.8524)and Jiangsu(13.9144),and the last three in the list were Tibet(0.0089),Qinghai(0.0570)and Inner Mongolia(0.1291).The top three of the ratio of doctor concentration to population concentration were Jiangsu(2.6852),Zhejiang(2.0537),Beijing(1.8608),and the last three in the list were Tibet(0.4629),Jiangxi(0.5469),Hunan(0.5797).The three provinces/regions with the ratio closest to 1 were Qinghai(0.9864),Henan(0.9653),and Fujian(0.9391).Conclusion There is still a demand for a great numbers of general practitioners,although the development trend of it in China shows a good prospect.The allocation of general practitioners is our of equilibrium and the growth rate is diverse across the regions.The registration rate of general practitioners is relatively at low level,so it is necessary to vigorously promote the construction of the general practitioner training system in China,strengthen the training and cultivation of general practitioners,and continuously improve the registration rate.Meanwhile it is needed to attach great importance to the equilibrium of general practitioner allocation across the region in China's Mainland.