上海市浦东新区社区卫生服务中心人力资源配置状况调查

A Comparative Study on the Human Resources Allocation of Community Health Service Centers in Pudong New Area

目的:分析上海市浦东新区社区卫生服务中心人力资源配置状况,为进一步优化社区卫生人力资源配置提供参考。方法:以2019年上海市浦东新区47家社区卫生服务中心年标化工作总量(全科医师承担部分)和服务人口数据为基础,计算各社区卫生服务中心人员的理论岗位数和理论编制数,采用配对样本t检验、Wilcoxon符号秩和检验、Kruskal-Wallis H检验,比较理论值与实际值的差异。结果:2019年浦东新区全区社区卫生服务中心编制缺口人数为(46±69)人,岗位缺口人数为(-2±48)人,理论编制人数和实际编制人数比较,差异有统计学意义(Z=-4.265,P<0.05)。区域分布分析发现,A类(偏远农村)、B类(一般农村)、C类(城郊结合)、D类(城区)社区卫生服务中心的编制缺口人数分别为(5±38)人、(61±75)人、(92±88)人、(35±48)人,差异有统计学意义(H=9.799,P<0.05)。各类人员缺口分析发现,全区全科医师、社区护士、公卫医师、其他人员的岗位缺口人数分别为(15±23)人、(4±17)人、(8±7)人、(-28±18)人,差异有统计学意义(H=91.954,P<0.05)。结论:应逐步提升基层卫生机构人员编制和岗位数量,优化人员配置结构,逐步精简其他辅助人员数量,以改善浦东新区社区卫生服务机构人员短缺现状,并从资源配置薄弱点入手,提高地区间卫生人力资源分布均衡性。

OBJECTIVE To analyze the allocation of community health human resources in Pudong New Area,and to provide references for further optimizing the allocation of resources.METHODS Based on the data of the total annual standardized work volume(the portion undertaken by general practitioners)and the population served by 47 community health service centers in Pudong New Area of Shanghai in 2019,the theoretical number of positions and the theoretical establishment of each community health service center personnel were calculated,and paired sample t-test,Wilcoxon signed rank sum test,and Kruskal-Wallis H-test were used to compare the theoretical values with differences of the actual values.RESULTS In 2019,the number of community health service centers across Pudong New Area had an establishment shortfall of 46±69 and a position shortfall of-2±48,with a statistical difference between the theoretical and actual establishment(Z=-4.265,P<0.05).The analysis of regional distribution found the number of establishment gaps in Class B of general rural(61±75),Class C of combined suburban(92±88)and Class D of urban(35±48)institutions were statistically significant(P<0.05).The analysis of different personnel gaps found the number of shortage of positions for general practitioners(15±23),community nurses(4±17),public health physicians(8±7),and other personnel(-28±18)were statistically significant(H=91.954,P<0.05).CONCLUSION The number of staffing and positions in primary health institutions should be gradually increased,while the staffing structure should be optimized and the number of other supporting staff should be gradually streamlined to improve the current situation of staff shortage in community health service institutions in Pudong New Area,and the balance of health human resources distribution among regions should be improved by starting from the weak point of resource allocation.