中国中小学校医队伍建设现状

Current status of school doctor personnel in primary and secondary schools in China

目的分析《学校卫生工作条例》实施以来中国学校校医队伍建设现状,为引发对中小学校医管理制度的思考提供依据。方法在中国东、中、西部选择有代表性的省份(江苏、山东、江西、河北、青海、陕西),通过定量研究和定性访谈进行混合方法研究。结果具有医学背景的校医占比为33.64%,部分校医(31.6%)尚未落实编制。校医在学校中地位较低,在收入、奖金分配、评优等方面较一线教师差距大,校医工资水平远低于教育行业和社会卫生保障福利业工资水平,有些地区甚至低于当地社会平均工资。薪酬水平呈现地域间不平衡,东部地区薪酬水平较高,中西部除个别地区,整体薪酬水平低。医学背景校医与非医学背景校医在最高学历、年收入水平、工作性质、是否在编、职业发展机会、收入满意度、福利待遇满意度和培训满意度之间差异均有统计学意义(χ^(2)值分别为10.73,26.64,313.44,14.13,29.14,13.22,12.97,19.44,P值均<0.05)。结论需充分重视中小学校医队伍建设,将学校卫生纳入公共卫生管理体系,划分校医管理主体,规范校医务室工作办法,畅通校医人事薪酬及职称晋升通道。

Objective This study analyzes the development of school doctor personnel since the implementation of the national"School Health Work Regulations",from the salary of school doctors,followed by the management system of school doctors in primary and middle schools.Methods Representative provinces in the eastern,central and western regions of China were selected and surveyed through quantitative and qualitative method.Results The proportion of school doctors with medical background accounted for 33.64%,31.6%school doctors had t o be established.A huge gap between income,bonus distribution and appraisal exsited between school doctors and school teachers.Wages of school doctors was much lower than that of education-and social health-sectors.The salary level showed regional imbalance,relatively higher in the eastern region and lower in the in the central and western regions with few exceptions.There were significant differences between medical background school doctors and non-medical background school doctors in the highest educational background,income level,job nature,job placement,career development opportunity,income satisfaction,welfare and training satisfaction(χ^(2)=10.73,26.64,313.44,14.13,29.14,13.22,12.97,19.44,P<0.05).Conclusion Government needs to pay attention to the school doctors in primary and secondary schools,integreate school health into public health management system.Relevant policies regarding school doctor management authority,school clinic and health center guideline,salary standards,as well as professional career development,are expected.