2010年至2015年乡村医生流入流出对比分析

摘要

Objective To analyze the current situation and influencing factors for the inflow and outflow of village doctors. Methods The stratified random sampling method was used to collect data on the flow of village doctors from 2010 to 2015. Thirty-six townships were sampled, which were located in 12 counties from 6 provinces in the eastern, central and western China respectively. Results The average age of sampled village doctors was 31. 25 ± 8. 75 years, and most of them graduated from technical secondary school(57. 21% ). The outflows were greater than the inflows, and the net inflow in the eastern region was highly negative. Among the outflows, those under 60 years old accounted for 44. 78%, and most of them went to medical institutions of higher level. 22. 26% of the outflows were under 40 years old, while 85. 42% of them had college degree or above, and 71. 72% were practicing(assistant) physicians. Conclusions The main force of village doctors is draining, with replenishment difficult to attract. Income and career prospects are the main causes for the loss. A model of rural doctors is thus recommended, combining such major elements as capabilities, motivations and opportunities for reinforcement of the teambuilding.%目的 分析我国乡村医生队伍流入和流出现状及其影响因素.方法 采用分层随机抽样方法,于2015年7—11月,对我国东、中、西部6省12县36个乡镇的2010年至2015年乡村医生流动情况进行资料收集,数据进行描述性分析.结果 抽样地区流入乡村医生平均年龄(31. 25 ± 8. 75)岁,以中专学历为主(57. 21% ).乡村医生流出人数多于流入人数,东部地区的净流入负值严重.在流出的乡村医生中,60岁以下者占44. 78%,主要流向上级医疗机构.其中,40岁以下者占总流出人群的22. 26%,大专及以上学历者占85. 42%,有执业(助理)医师资格者占71. 72% .结论 乡村医生队伍主力军流失,且新生力量补充困难.收入和职业发展前景,是引起流失的主要原因.建议构建集能力、动机和机会三大函数要素的乡村医生队伍建设模型,加强其队伍建设能力.