贵州省5个地区基层公共卫生服务人员配置情况分析

Basic public health service personnel allocation in five regions of Guizhou province

目的通过对贵州省5个地区基层公共卫生服务人员配置现状调查,为贵州省基层疾病预防控制体系构建和高校培养基层公共卫生服务人才提供办学参考和策略。方法根据贵州省地形特点,2019年7-10月对贵阳市、遵义市、六盘水市、黔西南布依族苗族自治州、黔南布依族苗族自治州5个地区的基层公共卫生服务人员进行分层随机抽样,对20个乡镇卫生院和20个社区卫生服务中心从事基本公共卫生服务的工作人员进行问卷调查和现场座谈。结果5个地区工作人员以女性(82.7%)、年龄25~<35岁(41.7%)、工作年限<5年者(65.7%)、初级职称(59.7%)占比较高;贵阳市本科学历占比最高(47.5%),其他地区均以专科占比最高;护理和临床专业分别占比40.3%和26.4%,全科及预防医学专业仅占3.2%;每万居民拥有公卫执业(助理)医师人数为0.05,一人多岗占43.5%。结论贵州省基层公共卫生服务人员专业结构不合理,公共卫生执业(助理)医师极度缺乏,职称结构偏低,编制不足,人员流失严重。

Objective To investigate basic public health service personnel allocation in five regions of Guizhou province,providing reference and strategies for the construction of grass-roots disease prevention and control system in Guizhou province and the training of grass-roots public health service talents in colleges and universities.Methods According to the topographical features of Guizhou province,stratified random sampling was completed in five regions including Guiyang,Zunyi,Liupanshui,Qianxinan Buyei and Miao Autonomous Prefecture,Qiannan Buyei and Miao Autonomous Prefecture.Questionnaires and on-the-spot symposiums were conducted among basic public health service personnel from 20 township health centers and 20 community health service centers.Results Women(82.7%),25-35 years of age(41.7%),working years<5 years(65.7%),and junior professional titles(59.7%)accounted for a higher proportion of the staff in the five regions.Basic public health service personnel in Guiyang had the highest percentage of undergraduate education(47.5%)and those in other regions had the highest percentage of a junior college education.40.3%and 26.4%of basic public health service personnel were devoted to nursing and clinical specialties,and only 3.2%of basic public health service personnel were devoted to general practice and preventive medicine.The number of public health practitioners(assistants)per 10,000 residents was 0.05,and 43.5%of public health practitioners had multiple duties.Conclusion The professional structure of public health personnel is not reasonable at the grass-roots level in Guizhou province.There is an extreme shortage of public health practitioners(assistants),the professional title is low,staffing is inadequate,and staff loss is serious.