湖北省两市儿科医师流动现状  

Current Situation of the Flow of Pediatricians in Two Cities in Hubei Province

作　　者：邵颖颖 刘建军[2] 李曰阳 钟正东 SHAO Yingying(Wuhan NO.1 Hospital,Wuhan,Hubei,430000,China)

机构地区：[1]武汉市第一医院,湖北武汉430000 [2]华中科技大学同济医学院附属武汉儿童医院,湖北武汉430014 [3]华中科技大学医药卫生管理学院,湖北武汉430000

出　　处：《医学与社会》2021年第12期90-93,99,共5页Medicine and Society

基　　金：国家自然科学基金资助项目,编号为72174068。

摘　　要：目的:调查儿科医师流入流失现状,分析存在问题,为我国儿科发展提出建议。方法:定量调查经济水平较高的宜昌市与较低的黄冈市儿科医师的流入流失情况,定性调查问题、成因。结果:2018年宜昌市儿科医师净流失人数占儿科医师总人数的4.8%,黄冈市为9.9%;宜昌市35岁以下、初级职称、本科等儿科医师群体离职占比较高,分别为75%、56%、94%;黄冈市45-60岁、中级职称、专科及以下学历等儿科医师群体离职占比较高,分别为32%、43%、64%。访谈显示,儿科医师流入少、流失多,原因在于收入与付出不匹配、宏观政策不完善、医师职业满意度不够。结论:儿科医师流出远多于流入,与儿科医学教育、政府投入机制、医疗服务价格机制、薪酬制度等不够完善有关。35岁以下、初级职称、本科等群体和经济欠发达地区流失更为严重,与多层次需求满足程度较低有关。应完善儿科医师培养体系,加强政府投入对儿科特别是欠发达地区倾斜,调整儿科医疗服务价格,完善医疗机构绩效分配机制,满足儿科医师多层次需求。Objective:To investigate the current situation of the inflow and loss of pediatricians,analyze the existing problems,and make suggestions for the development of pediatrics in China.Methods:Quantitatively investigate the inflow and outflow of pediatricians from Yichang with a higher economic level and Huanggang with a lower economic level,and qualitatively investigate the problems and causes.Results:In 2018,the net loss of pediatricians in Yichang accounted for 4.8%of the total number of pediatricians,and it was 9.9%in Huanggang City.In Yichang,pediatricians under the age of 35,junior titles,undergraduates and other groups of pediatricians leave their jobs relatively high,accounting for 75%,56%,94%respectively.Pediatric physicians aged 45-60,with intermediate professional titles,specialist degrees and below,and other groups of pediatricians who leave their jobs were relatively high in Huanggang,accounting for 32%,43%,and 64%respectively.Interviews showed that the inflow of pediatricians was low and the loss was high.The reason was the mismatch of income and expenditure,the imperfect macro policy,and insufficient professional satisfaction of doctors.Conclusion:The outflow of pediatricians is far more than the inflow,which is related to the incompleteness of pediatric medical education,government investment mechanism,medical service price mechanism,and salary system.Groups aged 35 and below,junior professional titles,undergraduates and other groups and economically underdeveloped areas are more severely drained,which is related to the lower degree of satisfaction of multi-level needs.The pediatrician training system should be improved;the government has invested in the implementation of pediatrics,especially in underdeveloped areas;adjusted the price of pediatric medical services;improved the performance distribution mechanism of medical institutions;the multi-level needs of pediatricians should be met.

关 键 词：儿科医师 流动 公平理论 需求层次理论 

分 类 号：R192.3[医药卫生—卫生事业管理]