2015—2020年天津市基层医疗卫生机构人力资源配置现状与公平性分析

Analysis on status and fairness of human resource allocation in primary health care institutions in Tianjin from 2015-2020

目的探析基层医疗卫生机构人力资源配置现状及其公平性,为天津在“十四五”新阶段优化基层卫生人力资源配置提供参考。方法用卫生人力资源密度指数、基尼系数和泰尔指数分析基层卫生人力资源配置的公平性。结果2015—2020年基层卫生人力资源数量年均增长速度为7.57%,医护比为1∶0.503~1∶0.520。基尼系数:人口为0.135~0.199、经济为0.418~0.494、地理为0.558~0.646。泰尔指数差异贡献率显示,地理维度的差异主要源于区域间,经济维度差异主要源于区域内,分别为89.98%~94.91%和48.71%~65.37%。结论基层卫生人力资源增速较慢,医护比结构失衡,按人口配置的公平性优于按经济、面积配置的公平性。建议要以优化基层卫生人力资源配置为核心,从人员结构、空间分布上做好各区规划,引导优质的医疗资源向经济发展水平低、资源匮乏的区域下沉,促进全市基层卫生人力资源的协同发展。

Objective To analyze the current situation and fairness of human resource allocation in primary health care institutions,provide reference for Tianjin to optimize the allocation of primary health human resources in the new stage of the"14th Five-Year Plan".Methods The health human resource density index,Gini coefficient and Theil index were used to analyze the fairness of primary health human resource allocation.Results The average annual growth rate of primary health human resources in 2015-2020 was 7.57%,and the ratio of doctors to nurses was 1∶0.503-1∶0.520.The Gini coefficient value was respectively:population(0.135-0.199),economy(0.418-0.494),and geography(0.558-0.646).The difference contribution rate of Theil index showed that the differences in geography originated mainly from inter regional differences,while the differences in economic dimensions mainly originated from within regions,which were 89.98%-94.91%and 48.71%-65.37%,respectively.Conclusions The growth of primary health human resources is slow,and the ratio of doctors and nurses is unbalanced.The fairness of allocation by population is better than that of allocation by economy and area.It is suggested that the allocation of primary health human resources should be optimized as the core,and each district should be well planned from the aspects of personnel structure and spatial distribution,the high-quality medical resources should be guided to sink into areas with low levels of economic development and resource scarcity,so as to promote the coordinated development of the grassroots health human resources in the city.