2015~2019年我国西部地区基层卫生人力资源配置情况分析  

Status of human resources allocation of primary healthcare in western China,2015-2019

作　　者：邓蒙 骆宣良 黄丹琪 覃娴静 徐婷婷 冯启明[1] 陈丽[1,2] DENG Meng;LUO Xuan-liang;HUANG Dan-qi;QIN Xian-jing;XU Ting-ting;FENG Qi-ming;CHEN Li(Health Policy Research Center of Guangxi Medical University,Nanning 530021,China;Hangzhou Zhongmei Huadong Pharmaceutical Co.,Ltd,Hangzhou 310011,China)

机构地区：[1]广西医科大学卫生与健康政策研究中心,南宁市530021 [2]浙江省杭州中美华东制药有限公司,杭州市310011

出　　处：《广西医学》2022年第3期319-324,共6页Guangxi Medical Journal

基　　金：广西研究生教育创新计划(YCSW2020130)。

摘　　要：目的分析2015~2019年我国西部地区基层卫生人力配置的现状。方法收集我国西部地区各省(自治区、直辖市)2015~2019年年末人口总数、2019年国内生产总值(GDP)及地理面积数据,以及2015~2019年卫生人员数、卫生技术人员数、执业(助理)医师数、注册护士数、乡村医生和卫生员数。根据2019年人均GDP水平,将西部地区划分为高人均GDP组、中人均GDP组、低人均GDP组。采用卫生资源密度指数(HRDI)、基尼系数、泰尔指数,分别从人口维度和地理维度对我国西部地区卫生人力资源的配置数量和公平性进行分析。结果(1)2015~2019年,除乡村医生和卫生员外,西部地区其余各项卫生人力资源的配置数量均为正增长,各项卫生人力资源的HRDI排序为:卫生人员>卫生技术人员>乡村医生和卫生员>执业(助理)医师>注册护士,各地区间差异较大。(2)在人口维度上,各项卫生人力资源的基尼系数均小于0.2,配置公平性高;在地理维度上,各项卫生人力资源的基尼系数均高于0.5,处于极度不公平状态。(3)从泰尔指数来看,在地理维度上,高人均GDP组卫生人力资源的配置公平性最差,经济发展较好的地区之间卫生人力资源配置更不平衡。结论2015~2019年我国西部地区乡村医生和卫生员的配置数量有所降低,不同省(自治区、直辖市)之间卫生人力资源配置水平差距较大,地理维度上各项卫生人力资源配置的公平性较差。卫生行政部门应加大对地理配置公平性的关注,在综合人口与地理因素的基础上测算卫生人力需求量,合理制定卫生人才规划,提高西部地区卫生人力资源地理覆盖率;同时,在“存量”的基础上,加强业务培训,有效地提升基层卫生人员的服务能力。Objective To analyze the status quo of human resources allocation of primary healthcare in western China between 2015 and 2019.Methods The gross population from 2015 to the end of 2019,gross domestic product(GDP)and geographic area data in 2019,as well as the number of medical staff,health technical personnel,licensed doctors/assistant doctors,registered nurses,and rural doctors and health workers between 2015 to 2019,were collected from various provinces(autonomous regions,centrally administered municipalities)in western China.According to the level of per capita GDP in 2019,the western regions were divided into high per capita GDP group,medium per capita GDP group and low per capita GDP group.Using health resource density index(HRDI),Gini coefficient and Theil index,the number and equity of western China′s health human resources allocation were analyzed in the demographic and geographic dimensions.Results(1)Between 2015 and 2019,except for rural doctors and health workers,the allocation quantities of the remaining items of health human resources in the western regions showed a positive increase,and the HRDI of various items of health human resources decreased in the order of medical staff,health technical personnel,rural doctors and health workers,licensed doctors/assistant doctors,and registered nurses,exhibiting a greater difference among regions.(2)In the demographic dimension,the Gini coefficients of various items of health human resources were all smaller than 0.2,showing a higher equity of allocation;in the geographic dimension,the Gini coefficients of various items of health human resources were all higher than 0.5,showing a state of extreme inequity.(3)As for Theil index,in the geographic dimension,the high per capita GDP group had the poorest equity of health human resources allocation and a more evident imbalance in health human resources allocation among regions of preferable economic development.Conclusion Between 2015 and 2019,the allocation number of rural doctors and health workers were decline

关 键 词：基层卫生人力资源 卫生人力资源密度指数 泰尔指数 基尼系数 公平性 西部地区 

分 类 号：R197.6[医药卫生—卫生事业管理]