中国贫困地区乡镇卫生院人力现状分析

乡镇卫生院是农村初级卫生保健的核心,是农村三级卫生网络的重要枢纽。乡镇卫生院卫生人力状况对乡镇卫生院保持良好的运转、发挥应有的功能具有重要意义。农村贫困地区由于受自然条件差、经济发展水平低等方面的限制,卫生人力问题已经成为制约农村卫生服务能力提高的一个瓶颈,直接影响着“人人享有卫生保健”目标的实际,对卫生公平性提出了挑战。本研究通过对中国农村贫困地区乡镇卫生院的抽样调查,了解其卫生人力现状及存在的问题,为制定解决农村贫困地区基层卫生人力资源建设问题的政策提供实证依据。     

浅析农村贫困地区卫生资源配置现状

卫生资源的合理配置,最大限度地满足该地区居民不同层次的医疗卫生服务的有效需求,使其充分发挥最大效率,是我们永恒的主题。而我国农村卫生工作存在的主要问题即是卫生资源配置的畸轻畸重,除城乡差异较大以外,农村贫困地区医疗机构的固定资产及设备情况,存在“一低二破”;在机构、床位和卫技人员上存在相对过剩,重要的是开发农民的卫生需求;提高自身技术实力,削除冗员,提高医技人员的综合素质。 农村贫困地区县医院大多是低水平运转,人员知识老化,设备陈旧,技术含量低等问题的根源是地区经济不发达所致。经济的腾飞将最大限度地改善农村贫困地区卫生服务落后局面。     

中国农村贫困地区乡镇卫生院与乡级教育机构人力状况的对比分析

为了解贫困地区乡镇卫生院与乡级教育机构人力的现状,本研究在全国抽取6个省(自治区、直辖市)贫困地区26个乡的121家乡镇卫生院与26所乡中学、26所乡小学的人力基本状况进行对比分析.结果显示:乡镇卫生院的学历层次低于乡中学、乡小学,乡镇卫生院卫技人员职称层次、年人均收入均低于乡级教育机构教师.建议:学习和借鉴教育领域教师工资国家统一规划、师范院校培齐模式、义务教育经费全面纳入财政保障范围、国家对教育硬件建设投资等作法.     

县级血吸虫病防治机构人力满意度研究

目的了解基层血防机构血防人员的深层次需要的满意状况,研究其与工作效率和质量的关系.方法使用横断面问卷调查的方法,对20个监测点和20个非监测点的血防人员进行调查.结果血防专业人员对血防机构的人际关系的满意度较好,但对血防机构的工作报酬和福利制度满意率很低.县级血防机构人力资源指数偏低,随着职务的升高,人力资源指数也呈现上升趋势,工作年限与人力资源指数的关系呈中间低、两头高的态势.结论提高职工的福利报酬,使之与相近行业可比,在机构内部的分配原则、用人机制、工作氛围等方面进行改革,增强组织的凝聚力,是改善血防人力满意度的可行方法.     

农村贫困地区2002年至2006年县级卫生机构人员流动状况调查

目的 了解农村贫困地区卫生人力发展状况.方法 抽样调查全国6个省13个样本县51家县级卫生机构2002年至2006年人员流动情况.结果 被调查贫困县每千人口卫生人员数均低于所在省的平均水平.县级机构流人人员数多于流出人员.人员流入中,应届毕业生就业占43.50%,调入占40.58%;中专及以上学历者占95.83%,卫技人员占87.17%.流出人员中,离退休人员占70.44%,调离占22.33%;中专及大专学历者分别占38.91%及21.09%,卫生技术人员占69.74%.结论 贫困县人均卫生人力仍较缺乏,需加大人才引进力度;县级卫生机构人员队伍有所优化,但仍有人才流失风险,应通过健全人才合理流动机制、引导医学院校毕业生就业等途径,加强贫困地区卫生人才队伍建设.     

农村贫困地区2002年至2006年县级卫生机构人员流动状况调查

Objective To probe into the HR development of healthcare professionals in poor rural areas. Methods 51 county-level healthcare institutions from 13 counties in six provinces were sampled to study the turnover from 2002 to 2006. Results The number of healthcare professionals per 1 000 population in the poor counties investigated was in average lower than that of counties in the same province; the inflow of personnel was higher than that of outflow. Of the inflow, 43. 50％ were fresh university graduates, and 40. 58％ were transferred from other organizations, 95.83％ have degrees of technical secondary schools and above, and 87. 17％ were healthcare professionals. 70. 44％ of the outflow were retirees, and 22. 33％ were transferred outside; 28. 00％ have only senior high school degrees or below, 69. 74％ were healthcare professionals. Conclusions The quality of healthcare personnel has been improved to some extent; but the risk of brain drain remains a challenge. An appropriate mechanism of personnel turnover should be built, and graduates from medical schools should be directed to reinforce healthcare teams in poor areas.     

农村贫困地区2002年至2006年县级卫生机构人员流动状况调查

Objective To probe into the HR development of healthcare professionals in poor rural areas. Methods 51 county-level healthcare institutions from 13 counties in six provinces were sampled to study the turnover from 2002 to 2006. Results The number of healthcare professionals per 1 000 population in the poor counties investigated was in average lower than that of counties in the same province; the inflow of personnel was higher than that of outflow. Of the inflow, 43. 50％ were fresh university graduates, and 40. 58％ were transferred from other organizations, 95.83％ have degrees of technical secondary schools and above, and 87. 17％ were healthcare professionals. 70. 44％ of the outflow were retirees, and 22. 33％ were transferred outside; 28. 00％ have only senior high school degrees or below, 69. 74％ were healthcare professionals. Conclusions The quality of healthcare personnel has been improved to some extent; but the risk of brain drain remains a challenge. An appropriate mechanism of personnel turnover should be built, and graduates from medical schools should be directed to reinforce healthcare teams in poor areas.     

农村贫困地区2002年至2006年县级卫生机构人员流动状况调查

Objective To probe into the HR development of healthcare professionals in poor rural areas. Methods 51 county-level healthcare institutions from 13 counties in six provinces were sampled to study the turnover from 2002 to 2006. Results The number of healthcare professionals per 1 000 population in the poor counties investigated was in average lower than that of counties in the same province; the inflow of personnel was higher than that of outflow. Of the inflow, 43. 50％ were fresh university graduates, and 40. 58％ were transferred from other organizations, 95.83％ have degrees of technical secondary schools and above, and 87. 17％ were healthcare professionals. 70. 44％ of the outflow were retirees, and 22. 33％ were transferred outside; 28. 00％ have only senior high school degrees or below, 69. 74％ were healthcare professionals. Conclusions The quality of healthcare personnel has been improved to some extent; but the risk of brain drain remains a challenge. An appropriate mechanism of personnel turnover should be built, and graduates from medical schools should be directed to reinforce healthcare teams in poor areas.     

农村贫困地区2002年至2006年县级卫生机构人员流动状况调查

Objective To probe into the HR development of healthcare professionals in poor rural areas. Methods 51 county-level healthcare institutions from 13 counties in six provinces were sampled to study the turnover from 2002 to 2006. Results The number of healthcare professionals per 1 000 population in the poor counties investigated was in average lower than that of counties in the same province; the inflow of personnel was higher than that of outflow. Of the inflow, 43. 50％ were fresh university graduates, and 40. 58％ were transferred from other organizations, 95.83％ have degrees of technical secondary schools and above, and 87. 17％ were healthcare professionals. 70. 44％ of the outflow were retirees, and 22. 33％ were transferred outside; 28. 00％ have only senior high school degrees or below, 69. 74％ were healthcare professionals. Conclusions The quality of healthcare personnel has been improved to some extent; but the risk of brain drain remains a challenge. An appropriate mechanism of personnel turnover should be built, and graduates from medical schools should be directed to reinforce healthcare teams in poor areas.     

农村贫困地区2002年至2006年县级卫生机构人员流动状况调查

Objective To probe into the HR development of healthcare professionals in poor rural areas. Methods 51 county-level healthcare institutions from 13 counties in six provinces were sampled to study the turnover from 2002 to 2006. Results The number of healthcare professionals per 1 000 population in the poor counties investigated was in average lower than that of counties in the same province; the inflow of personnel was higher than that of outflow. Of the inflow, 43. 50％ were fresh university graduates, and 40. 58％ were transferred from other organizations, 95.83％ have degrees of technical secondary schools and above, and 87. 17％ were healthcare professionals. 70. 44％ of the outflow were retirees, and 22. 33％ were transferred outside; 28. 00％ have only senior high school degrees or below, 69. 74％ were healthcare professionals. Conclusions The quality of healthcare personnel has been improved to some extent; but the risk of brain drain remains a challenge. An appropriate mechanism of personnel turnover should be built, and graduates from medical schools should be directed to reinforce healthcare teams in poor areas.     

安吉县农村社区卫生服务机构一体化管理的实践与成效

浙江省安吉县卫生局近3年在一体化管理方面做了积板有效的探索,取得了明显的成效。文章就该县农村社区卫生服务机构一体化管理的做法和成效做了总结。     

The Keokuk County Rural Health Study

ABSTRACT

The Keokuk County Rural Health Study is a unique, population-based, prospective study of an agricultural community. The study is expected to continue for twenty years. The research includes systematic assessment of respiratory disease, injury, and other health outcomes in relation to agricultural, occupational, and environmental exposures. The aims of the environmental surveys are: (1) to conduct a systematic assessment of rural households in order to characterize the environmental exposures associated with the resi-dences and properties of the study subjects comparing farm, rural non-farm, and town households; and (2) to characterize occupational exposures associated with activities of the study subjects, particular-ly those related to farming and the rural environment. The environ-mental surveys consist of a combination of personal interviews, walk-through observations, and measurement of a selected number of environmental parameters. The focus of these assessments is on the environment and operations of the household and farm. Four instruments are used to record data: a Home Environmental Ques-tionnaire; a Home/Grounds Environmental Checklist; a Farm Envi-ronmental Questionnaire; and a Farm Environmental Checklist. Pre-liminary results from the first 106 environmental assessments are described, including the first 26 farms. More than half of residences were built before 1950, and they are primarily heated with liquid propane gas, natural gas, or wood. Dangerously high levels of car-bon monoxide were measured in several homes during winter 1995/96. Only 77 of 148 smoke detectors functioned. Farms ranged from 7 to 1,600 acres, with a mean of 324 acres. Eleven raised swine in enclosed systems. The average age of tractors in use was 26 years. Twenty-eight percent of all tractors had cabs, 25% had ROPS, and 39% had PTO shields.     

The Keokuk County Rural Health Study

SUMMARY

The Keokuk County Rural Health Study is a population-based, prospective study of environmental exposures and health status of a large randomly-selected sample of residents from each of three strata in one rural Iowa county. The study focuses on injury rates and respiratory disease; in addition, it monitors health care de-livery; geriatric, reproductive, and mental health; and other health outcomes. Injury and disease prevalence are investigated in relation to occupational, agricultural, and other environmental exposures. This paper describes the sampling method, the protocol, and the demographic profile of adult subjects of the first 400 households en-rolled in the study. Farmers were slightly younger than rural non-farmers and townspeople and more farmers had lived in the county all of their lives. Females were more highly educated than were males, and less than half as many female farmers had lived in the county all their lives than had male farmers. Net household income figures were complex and are shown in a graph in Table 1.     

农村县级卫生机构功能定位及调整政策研究

1996年全国卫生工作会议制定的我国新时期卫生工作方针把“以农村为重点”列为首位 ,明确指出了解决农村卫生问题的重要性。我国长期以来形成的县、乡、村三级卫生保健网是农村卫生工作的基本载体 ,对保障农村居民健康 ,促进农村经济发展等方面发挥了巨大作用。但我国县级卫生机构的设置和运行仍然是计划经济体制下的产物 ,作为农村三级医疗预防保健网的“龙头” ,其业务骨干和业务领导作用正逐渐减弱。因此对县级卫生机构进行调整与改革 ,明确其职责 ,是促进县级卫生机构运行机制步入良性循环的关键所在。本文首先对计划经济体制下县级卫生…     

我国农村基层医疗机构人力资源配置研究：基于29省乡镇卫生院数据

卫生人力资源是影响乡镇卫生院发展的重要因素。文章首次构建综合评价指标体系,以中国29省乡镇卫生院数据为样本,评价我国农村基层医疗机构人力资源配置情况。实证研究结果表明,我国乡镇卫生院核心人力资源配置在较大程度上关注了当地的健康水平状况,配置公平性较好。同时,核心人力资源配置水平公平性及整体公平性差距不大,均略高于临界值。其中核心人力资源配置与当地经济发展水平具有较好的一致性。     

我国职业化卫生管理队伍建设的演化进程

职业化卫生管理队伍建设是深化卫生改革和加快发展的客观要求,本文通过对我国卫生管理队伍建设的历史回顾,进一步阐述职业化卫生管理队伍建设提出的依据和演化进程及其发展趋势。     

Modeling the Mental Health Workforce in Washington State: Using State Licensing Data to Examine Provider Supply in Rural and Urban Areas

CONTEXT: Ensuring an adequate mental health provider supply in rural and urban areas requires accessible methods of identifying provider types, practice locations, and practice productivity. PURPOSE: To identify mental health shortage areas using existing licensing and survey data. METHODS: The 1998-1999 Washington State Department of Health files on credentialed health professionals linked with results of a licensure renewal survey, 1990 US Census data, and the results of the 1990-1992 National Comorbidity Survey were used to calculate supply and requirements for mental health services in 2 types of geographic units in Washington state-61 rural and urban core health service areas and 13 larger mental health regions. Both the number of 9 types of mental health professionals and their full-time equivalents (FTEs) per 100,000 population measured supply in the health service areas and mental health regions. FINDINGS: Notable shortages of mental health providers existed throughout the state, especially in rural areas. Urban areas had 3 times the psychiatrist FTEs per 100,000 and more than 1.5 times the nonpsychiatrist mental health provider FTEs per 100,000 as rural areas. More than 80% of rural health service areas had at least 10% fewer psychiatrist FTEs and nonpsychiatrist mental health provider FTEs than the state ratio (10.4 FTEs per 100,000 and 306.5 FTEs per 100,000, respectively). Ten of the 13 mental health regions were more than 10% below the state ratio of psychiatrist FTEs per 100,000. CONCLUSIONS: States gathering a minimum database at licensure renewal can identify area-specific mental health care shortages for use in program planning.     

Assessing Competencies of the Public Health Workforce in a Frontier State

The purpose of this study was to determine the level of perceived proficiency of a public health workforce based on the Public Health Practice Core Competencies. The Public Health Profile and Training Needs Assessment questionnaire was mailed out to public health employees representing mostly public health nursing, environmental health, mental health, and public health management/administration (n = 696). Nearly three-quarters (74%) of participants were female and 96% reported being white. Eighty one percent of participants were currently employed full-time. The majority of participants were trained at the bachelors level (54%). The response rate was 63.9%. Findings from this study show that all disciplines reported higher perceived proficiency in the Communication skills domain compared to the other seven skills domains. Perceived low skills domains included financial planning and management skills and policy development/program planning skills among public health nurses, mental health professionals, and environmental health specialists. Management/administration level staff reported their lowest perceived proficiency in Basic Public Health Science skills. Each group had different strengths and weaknesses and the necessary level of skill needed differs among discipline groups, thus future trainings on the Public Health Core Competencies should be discipline specific.     

农村地区基层卫生人力资源配置分析

目的 调查分析我国农村地区基层卫生机构人力资源分布基本情况.方法 通过问卷调查方法收集样本地区12个县基层卫生机构卫生人力资源资料.结果 乡镇卫生院卫生技术人员中专及以下学历人员占 52.31%,初级职称人数占56.82%,乡镇卫生院的医护比为1∶0.34;村卫生室卫生人员无任何学历的占14.55%,没有职称的占49.98%,村卫生室医生执业化程度不到10%.结论 农村基层地区卫生人力学历职称偏低、配置不合理、执业化程度较低,需要加强农村地区卫生人员队伍建设.