我国基层全科医生队伍现状和继续医学教育内容需求分析

目的 调查目前基层全科医生队伍现状以及继续医学教育内容需求情况,为进一步改善基层全科医生配置和继续医学教育政策提供依据。 方法 采用整群随机抽样和方便抽样相结合的方法,2017年5月在我国东中西部13个省共抽取54家基层医疗卫生机构作为样本单位,对其中全科医生共670人进行问卷调查,采用EpiData 3.1录入数据并核对。 结果 调查机构平均每万人口全科医生数量为3.46人,东部地区最高,为4.12人,中部和西部分别只有1.45人和1.93人。不同省份平均每万人口全科医生数差异较大,以湖南省最低,平均只有0.76人;江苏省和浙江省最多,分别有5.55人和5.75人,是湖南的7倍多。参与调查的全科医生,年龄主要集中在30~50岁,学历以本科为主,占70.51%;中级职称最多,占43.97%。另外,城市地区基层全科医生学历比农村地区高,高级职称全科医生占比在东部地区最高。继续医学教育内容需求调查发现,疾病诊疗、合理用药和急诊急救等医疗服务相关内容需求较大;但不同地区、学历和职称的全科医生需求有所不同,高职称、高学历的全科医生更愿意接受新理论新技术等方面的继续医学教育内容。 结论 目前我国平均每万人口全科医生数已达标,但却存在明显的区域性差异。近些年基层全科医生的学历层次和职称水平不断提高,但不同地区发展也不平衡。另外,根据需求,应针对不同地区、职称和层次的全科医生开展不同的继续医学教育内容。 

Current situation of primary general practitioners and demand on continuing medical education content in China

Objective To investigate the current situation of primary general practitioners and demand on continuing medical education content in China, and to provide scientific evidences for general practitioners development and continuing medical education policy. Methods Cluster random sampling and convenient sampling method were used in this study. In May, 2017, a questionnaire survey was carried out among 670 general practitioners from 54 Primary health institutions of 13 Provinces in China. EpiData 3.1 was used to enter and verify data. Results It was found that the average number of general practitioners per million populations was 3.46 in institutions surveyed. The number of the eastern region was highest (4.12), whereas the central and western regions were only 1.45 and 1.93, respectively. The number also varied greatly in different provinces, which was lowest in Hunan province (0.76) while was 5.55 and 5.75 in Jiangsu and Zhejiang province respectively. Among the primary general practitioners, most aged from 30 to 50 years old. And 70.51% of the primary general practitioners were undergraduate degree, mostly with intermediate title, accounting for 43.97%. In addition, general practitioners in city had higher education degree than the rural, and proportion of general practitioners with senior titles was highest in the eastern regions. Demand on continuing medical education content survey found that the demand on continuing medical education content was concentrated in medical technology; however, the needs of general practitioners differ in different regions, educational backgrounds and professional titles. The general practitioners with higher professional title or highly educated were more willing to accept the education of new theory and new technology. Conclusions The average number of general practitioners per million populations was up to standard in China, but there were obvious regional differences. In recent years, the education level and professional title of primary general practitioner had constantly improved, but the development was also unbalanced in different areas. In addition, continuing medical education should meet different needs of the primary general practitioners in different contents.