新医改政策实施前后我国乡镇卫生院卫生人才队伍建设比较研究

摘要

目的：本研究通过对新医改政策前后我国乡镇卫生院卫生人才队伍建设现状进行比较研究，探索新医改政策对乡镇卫生院卫生人才队伍建设的影响，并提出相应的策略。方法2011年4-9月，对北京、浙江、山西、安徽、贵州和云南6个省市100名乡镇卫生院管理者和750名乡镇卫生院医务人员进行问卷调查，对13名区县卫生局管理者、11名乡镇卫生院管理者、11名乡镇卫生院医务人员进行个人深入访谈。调查其职称、学历等情况。结果在2007-2010年，6省市乡镇卫生院卫生人才平均数量呈现逐年上升的趋势。各地人才队伍年龄逐步趋于年轻化，卫技人员平均年龄以26~35岁和36~45岁两个年龄段居多。2010年浙江有近70％以上的人员具有大专以上学历，北京、贵州和云南有60％左右的人员具有大专以上学历，山西和安徽有近40％的大专以上人员。被调研6省市乡镇卫生院卫生人才的职称仍以初中级为主，且均存在一定比例的尚未评定职称人员。从2007年和2010年被调研6省市乡镇卫生院卫生人才队伍的培训和进修情况比较来看，各省市均有显著的增长。结论我国乡镇卫生院卫生人才队伍数量呈现增长态势，但地区间分布不均衡；学历有所提高，但有待提升；职业发展空间受限，执业化进程缓慢。需要转变基层卫生人才的培养理念、加快培养进程、拓展职业发展空间，提升整体学历水平，实现基层卫生人才的有力供给。%Objective We compare the present situation of construction of rural health care personnel before and after the New Medical System Reform policy and explore the impact of the New Medical System Reform policy and in the end propose corresponding strategies. Methods From April to September,2011 we conducted a questionnaire survey of 6 provinces:Bei-jing,Zhejiang,Shanxi,Anhui,Guizhou and Yunnan and 100 township health center managers and 750 rural medical staff, carried out in-depth interviews about educational background and professional title of the managers in 13 district and county Health Bureaus,11 township hospitals and medical staff in 11 township health centers. Results In 2007 and 2010,the average number of health personnel in township health centers in 6 provinces and cities showed a rising trend year by year. All personnel tended to be younger,and the average age of health technical personnel were around two age stages:26 -35 and 36 -45. In 2010,nearly more than 70% of the staff in Zhejiang had associate degree or above,about 60% in Beijing,Guizhou and Yunnan and about 40% in Shanxi and Anhui. Their professional titles in the 6 provinces were mainly primary and intermediate and had a certain proportion of staff without assessed titles. Seen from the comparing research of training and attendance from 2007 and 2010 , a significant growth was found in all the cities and provinces investigated. Conclusion The number of health care personnel in township hospital centers in China is increasing,but many problems still exist such as uneven distribution among regions,not very high educational background,restricted career development,etc. To realize effective supply of basic level health personnel, it is necessary to change the training thought,speed up the training process,expand the occupation development space and in-crease all staff's educational background.