湖北省乡镇卫生院人员流动原因及去向分析

目的 了解湖北省乡镇卫生院医务人员流动特点，为加强乡镇卫生院卫生人力资源建设提供决策依据。方法 采用分层随机抽样方法抽取湖北省宜昌、孝感、恩施3个市（州）的24个乡镇卫生院为调查对象，通过问卷调查和半结构化访谈的形式了解卫生院人员流动原因及去向。结果 2008—2012年乡镇卫生院年均净流入人数分别为宜昌2.20人（0.66%）、孝感12.80人（2.37%）、恩施-9.40人（-2.31%）；不同地区乡镇卫生院人员流入及流出原因差异均有统计学意义（χ²=53.074、48.483，P<0.05）；宜昌、孝感、恩施录取的应届毕业生分别为流入人员总数的34.75%、11.11%、2.70%；流出原因中调出所占比重分别为32.71%、59.15%、52.38%，年均净调入率分别为-0.10%、-0.56%、-1.57%；三地人员流出去向均以更高级别医疗机构为主，所占比例依次为宜昌43.00%、孝感61.97%、恩施59.52%。结论 欠发达地区人员流失问题突出；过度调动影响卫生人才队伍的稳定性；卫生人才系统外流失问题不容忽视。

Reasons and destination features of medical personnel flow in township hospitals in Hubei province

Objective To analyze features of medical personnel flow in township hospitals in Hubei province and to provide a basis for human resource construction in township health institutions.Methods Stratified random sampling was used to select 24 township hospitals in Yichang, Xiaogan, and Enshi city in Hubei province.With questionnaire survey and semi-structured interview, we collected information on reasons and destination of township hospital staff mobility.Results From 2008 to 2012, the average annual number of net inflows of medical staff to a township hospital was 2.20 persons in Yichang(0.66%), 12.80 in Xiaogan(2.37%), and -9.40(-2.31%) in Enshi with significant differences(χ²=53.074, 48.483, P<0.05).The graduate inflow rate for Yichang, Xiaogan, and Enshi was 34.75%, 11.11%, and 2.70%, respectively.For the outflow of medical workers, the transfer proportion was 32.71%, 59.15%, and 52.38% for Yichang, Xiaogan, and Enshi, with the average annual net inflow rate of -0.10%, -0.56%, and -1.57%, respectively.The outflow of medical workers from township hospitals was mainly towards medical institutions of highe-ranking, with the ratio of 43.00% for Yichang, 61.97% for Xiaogan, and 59.52% for Enshi city.Conclusion The medical staff turnover for township hospitals in underdeveloped regions is serious and the excessive mobilization affect the stability of health human resource, suggesting the problem needs to be concerned.