浙江省卫生人力资源配置及公平性研究

A study on the status and equity of human resource allocation for health in Zhejiang Province

目的了解浙江省卫生人力资源配置及公平性状况,为政府优化卫生人力资源配置提供依据。方法根据2012—2016年《浙江卫生年鉴》等资料,描述性分析2011—2015年浙江省卫生人力资源配置情况,采用年度变化百分比(APC)分析发展趋势,利用基尼系数进行公平性评价。结果 2015年浙江省每千人拥有卫生人员数以杭州最多,为12.62人,嘉兴最少,为7.43人;卫技人员杭州最多,为10.32人,温州最少,为6.23人;执业(助理)医师杭州最多,为3.86人,嘉兴最少,为2.15人;注册护士杭州最多,为4.23人,温州最少,为2.42人;每平方千米拥有卫生人员、卫技人员、执业(助理)医师和注册护士数以嘉兴最多,分别为8.06、7.03、2.33和2.86人;丽水最少,分别为1.21、1.00、0.39和0.38人;全省医护比为1∶1.01。2011—2015年浙江省每千人和每平方千米卫生人力资源数逐年上升,其中注册护士升幅最大,APC分别为9.53%和9.86%。上述卫生人力资源各指标的历年基尼系数按服务人口评价均在0.2以下,按服务面积评价均在0.2~0.3之间。结论浙江省卫生人力资源配置呈上升态势,总体公平性高,但基于服务人口配置公平性高于基于服务面积,需关注卫生人力资源区域可及性研究。

Objective To learn the status and equity of human resource allocation for health so as to provide evidence for health administrative department. Methods Descriptive analysis and annual percent changes(APC) were used to analyze the numbers and trends of human resource allocation for health from 2011 to 2015,and Gini coefficients were used for equity evaluation. Results In 2015, Hangzhou had the largest number(12.62) of medical personnel per 1000 persons while Jiaxing had the least amount(7.43). Hangzhou had the largest number(10.32) of medical technical personnel per 1000 persons while Wenzhou had the least amount(6.23). Hangzhou had the largest number(3.86) of licensed(assistant) doctors per 1000 persons while Jiaxing had the least amount(2.15). Hangzhou had the largest number(4.23) of registered nurses per 1000 persons while Wenzhou had the least amount(2.42). Jiaxing had 8.06 medical personnel,7.03 medical technical personnel,2.33 licensed(assistant) doctors and 2.86 registered nurses per square kilometer which were all the largest number while Lishui had 1.21 medical personnel, 1.00 medical technical personnel,0.39 licensed(assistant) doctors and 0.38 registered nurses per square kilometer which were all the least. The doctor-to-nurse ratio was only 1∶1.01 in 2015. Both numbers of human resources for health per 1000 persons and per square kilometer increased year by year from 2011 to 2015, and Gini coefficients of each index expressed by per 1000 persons were all under 0.2, while it ranged from 0.2 to 0.3 when they were expressed by per square kilometer.Conclusion Numbers of human resource allocation for health had an increasing trend and the allocation was fair,but the equity evaluated by service population was better than by service areas,and the research about accessibility of regional human resource allocation for health needs to be concerned.