县乡村三级卫生人力资源的构成与分布特征研究

目的 通过分析县乡村三级人力资源配置的内部构成及各级机构间的分布差异情况,为农村卫生人力资源的纵向整合和三级医疗预防保健网的建设提供依据。 方法 用EXCEL2010分析各级医疗机构的人口学特征及内部构成比,用SPSS20.0进行卡方检验分析不同级别,不同地域类型的医疗机构卫生人员的构成与分布是否存在差异。结果 总体上男性医务人员多于女性医务人员,但由于村卫生室以乡村医生为主,所以医务人员的内部构成比例和性别分布情况与县乡两级机构不同。60岁及以上人员在县级医疗机构为2.69%,在村卫生室的比例达27.51%（P<0.05）。与2014年相比,2015年该市乡镇卫生院人员引进了15人,流失了27人,而县级医院引进了50人,流失了24人。结论 分级诊疗相关政策影响农村卫生人力资源的配置和床日负担水平,县乡村三级医疗机构医务人员的性别年龄分布均有差异,不同地域类型乡镇卫生院均需对高学历医务工作者给予针对性的激励措施。

Study of the Composition and Distribution Characteristics of the Three-Level Human Resources in the County Rural Area

Objective To analyze the differences in distribution among the human resources in county, town and village level hospitals, and provide evidences for policy recommendations on vertical integration of rural health human resource and construction in tertiary medical prevention health care network. Methods EXCEL2010 was used to analyze the demographic characteristics and internal composition of medical institutions at all levels, and SPSS20.0 was used to carry out chi square test to analyze the differences in the composition and distribution of health personnel in medical institutes of different levels in a county. Results On the whole, the male medical staff are more than female medical staff, and there is a great difference in gender and number between rural practitioners in village clinics and practitioners in county and township hospitals. Persons over the age of 60 at the county level medical institutions only account for 2.69%, while the village practitioners over 60 took up 27.51% (P<0.05). Compared with 2014, there are 15 people introduced and 27 people lost in township health centers, while there are 50 people introduced and 24 people lost in the county hospital in 2015. Conclusion The relevant policies of grading diagnosis and treatment may affect the configuration and distribution of rural health human resources and their workload. And difference exists in age and sex distribution of medical personnel among medical institutions of county, town and village levels. Special incentive measure need to be taken for township health center and village clinics.