2016-2020年北京市卫生人力资源配置及公平性分析

Analysis on the health human resources allocation and the equity in Beijing from 2016 to 2020

[目的]分析比较2016年和2020年北京市卫生人力资源配置现状及公平性,为“十四五”期间优化配置卫生人力资源提供依据。[方法]对北京市卫生人力资源配置的变化情况进行描述性分析,综合运用洛伦兹曲线、基尼系数、阿特金森指数及泰尔指数研究卫生人力资源配置的公平性。[结果]2020年,北京市共有卫生技术人员303699人,其中执业(助理)医师118541人,注册护士134656人;每千人口卫生技术人员、执业(助理)医师、注册护士分别为13.87人、5.41人和6.15人;每千平方公里卫生技术人员、执业(助理)医师、注册护士分别为18.51人、7.22人和8.21人。2016年、2020年对应的卫生技术人员基尼系数值分别为0.246、0.292;2020年北京市卫生技术人员数、执业(助理)医师数、注册护士数按人口配置的阿特金森指数分别为0.240、0.237和0.252,相较于2016年值均有升高。[结论]北京市当前卫生人力资源疏解与人口疏解不相匹配,2020年北京市卫生人力资源配置整体公平性有所下降,区域间公平性差异有所扩大;卫生人力资源的地理公平性仍有待提升。应通过重视护理人才队伍的培养、加强政府对医疗卫生人力资源的规划与管理、优化创新医疗服务模式等途径,促进卫生人力资源合理配置。

Objective To analyze and compare current situation and equity of health human resource allocation in 2016 and 2020 in Beijing so as to provide references for optimizing health human resource during the“14th Five-Year Plan”period.Methods The changes of health human resources allocation in Beijing were descriptive analyzed,and the fairness of health human resources allocation was studied comprehensively by Lorentz curve,Gini coefficient,Theil and Atkinson index.Results In 2020,there were 303,699 health workers,in which 11,8541 were practice(assistant)physicians,134,656 were registered nurses in Beijing.According to the distribution of permanent population,the health technician,practice(assistant)physician and registered nurses per thousand population was 18.51,7.22 and 8.21 respectively.The Gini coefficient value of health technician in 2016 and 2020 was 0.246 and 0.292 respectively.The Atkinson index of health technician,practice(assistant)physician and registered nurses by population in 2020 was 0.240,0.237 and 0.252 respectively,which were higher compared with in 2016.Conclusions There is a mismatch between the current human resource relief and population relief in Beijing.The overall fairness of health human resources allocation in Beijing has declined,inter-regional differences in equity has expanded.The geographical fairness of health human resources still needs to be improved.Promote rational allocation of health human resources should be by paying attention to the training of nursing personnel,strengthening the government s planning and management of medical and health human resources,and optimizing the innovation of medical service mode.