我国医药卫生人才队伍发展策略研究
摘要
目的：
为树立“人才资源是第一资源”的意识,建设一支高素质卫生技术人才队伍,确保卫生事业更好地为现代化建设和人民健康服务,根据卫生部《中国2001-2015年卫生人力发展纲要》和《中共中央国务院关于深化医药卫生体制改革的意见》等文件精神,结合我国社会经济及人口状况,以及医药卫生人才队伍建设的实际情况,对我国医药卫生人才队伍建设现状、存在的问题和发展趋势进行系统分析,并详细阐述国际上一些可借鉴的经验,为制定《全国人才队伍建设中长期规划纲要(2009—2020年)》提供科学的决策依据。
方法：
通过文献研究系统梳理医药卫生人才队伍建设的相关理论,以及系统回顾医药卫生人才队伍的相关政策；通过描述性统计学方法,分析我国医药卫生人才的发展现状；运用趋势外推法预测我国卫生人员未来增长趋势；采用专家咨询法验证医药卫生人才队伍发展策略的可行性和可操作性。
结果与结论：
1.我国医药卫生人才队伍建设进展：医药卫生人员总量持续增长,2010年,全国卫生人员总数为820万人,比2005年增加175万人；医药卫生人员结构得到改善,2010年与2005年相比,农村执业(助理)医师所占比例增加1.4个百分点,2010年与2005年相比,西部地区卫生人员和注册护士所占比例分别增加0.2个百分点,2010年与2005年相比,个人办医疗卫生机构卫生技术人员所占比例增加1.6个百分点；医药卫生人员素质能力不断提升,2010年与2005年相比,博士卫生技术人员所占比例增加2.9个百分点,硕士所占比例增加12.7个百分点；医药卫生人才制度规范不断完善。
2.我国医药卫生人才队伍发展面临的问题和挑战：高层次人才队伍建设基础薄弱,2010年,卫生技术人员仍以中专和大专为主,本科及以上学历所占比例仅为24.9%,高级卫生技术人员仅占7.8%；配置不合理,人才短缺与人才过剩并存,2010年,城乡每千人口卫生技术人员数分别为7.62人和3.04人,城市是农村的2.5倍。2010年,东、中、西部地区每千人口卫生技术人员数分别为5.22人、3.93人和3.76人。2010年,医疗机构拥有全国91.1%的卫生技术人员,而疾病预防控制中心仅拥有2.5%。2010年,我国仅有全科医师5.6万人,仅占执业(助理)医师总数的3.5%,远低于国际30%-60%的平均水平。2010年,我国医护比为1：0.85,远低于经合组织国家的比例(1：3.09)；同时,卫生人才难以满足社会快速增长的多层次卫生服务需求；人才培养与社会需求之间存在矛盾；人才队伍管理滞后；人才队伍相关法律法规和制度建设亟待加强；中医药人才队伍建设与服务需求、学术发展、产业发展不相适应。
3.我国医药卫生人才队伍发展趋势：经济、社会发展和人口变化对医药卫生人才需求将进一步增强；健康需求的变化对医药卫生人才队伍提出了更高的要求；国家工作重点的转变要求与之匹配的医药卫生人才队伍；到2020年,预计需要卫生人员1067.0万人,其中卫生技术人员914.4万人。
4.国际经验：我国医生密度略高于全球平均水平,但是与发达国家相比差距较大；中国的医护比为1：0.85,低于全球平均水平(1：2.9)；欧洲各国寻求各种不同的方式来改善卫生人力资源的利用效率与效果；其他国家构建了合理的高等医学教育学制体系；其他国家建立了比较完善的全科医学终生教育体系,包括全科医学的高等医学院校教育(主要是设立必修课和选修课)、毕业后医学教育和继续医学教育；其他国家积极采取改善农村卫生人力不足的措施。
建议：
1.实施“2020人才强卫工程”
2.分类建设六支核心医药卫生人才队伍；
3.加强医药卫生人才的能力培养与开发；
4.构筑医药卫生人才的研究和服务平台；
5.加大医药卫生人才队伍建设的投入力度；
6.完善医药卫生人才管理的法律和机制；
7.促进医药卫生人才的医德医风建设。
Objective:
To provide a scientific basis of decision-making for "Middle and Long-term Development Program of the Talents in China(2009-2020)", set up a the sense of "human resource is the first resource", establish a team of high-quality professional health care talents, and ensure that health care better services the modernization and people's health, according to the spirits of the documents of "Health Manpower Development Program from2001to2015in China" and " Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform", combined the socio-economic and demographic situation in our country, and the actual situation of the establishment of professional health care talents, the paper systematically analyses status quo, problems and development trends of professional health care talents, as well as elaborates a number of useful international experience.
Methods:
Construction theories related to professional health care talents and policies concerning professional health care talents are systematically reviewed through the literature review method; The status quo of professional health care talents is analyzed through the descriptive statistics method; And the future growth trend of professional health care talents is forecasted through rend extrapolation; The feasibility and operability of development strategies of professional health care talents are validated through expert consult method.
Results and Conclusions:
1. Construct development of professional health care talents in China: The total of health personnel continuously increases, and in2010, the total amount of national health personnel was8,200,000, which was1,750,000more than the amount in2005; Health personnel structure has improved, and compared to that in2005, the proportion of rural practitioners (assistant) physicians in2010increased1.4percentage points. Compared to that in2005, the proportion of health personnel and registered nurses in2010in western area in China respectively increased0.2percentage points. Compared to that in2005, the proportion of health professionals in private individuals do medical institutions health technical personnel proportion increased1.6percentage points:The ability and quality of health personnel continuously upgrades, and compared to that in2005, the proportion of health professionals who had doctor degree in2010increased2.9percentage points, the proportion of health professionals who had master degree in2010increased12.7percentage points; Personnel system of health care continuously improves.
2. Problems and challenges faced by the development of professional health care talents in China:Development basis on high-level talent in health care system is weak, and in2010, secondary school and junior college health professionals accounted for the large proportion, and undergraduate and above health professionals accounted for just24.9%, however senior health professionals accounted for only7.8%; Professional health care talents allocation is irrational, and talents shortage and surplus coexist, and the number of health professionals per thousand people in urban in2010was7.62, but that in rural in2010was3.04, and the number of health professionals per thousand people in urban is2.5times more than that in rural. The number of health professionals per thousand people in East, Middle and West in2010was respectively5.22,3.93and3.76. In2010, health professionals in medical institutions accounted for91.1%, however, health professionals in CDC accounted for only2.5%. In2010, the number of general practitioners in China was56,000, which accounted for3.5%of practitioners (assistant) physicians, and lower than the global average level (30%-60%). The proportion of doctors to nurses is1:0.85, lower than the OECD countries average level (1:3.09); Professional health care talents can not meet the demand of the rapid growth and multi-level health service; Professional health care talents training conflicts with social needs; Professional health care talents administration lags behind; Laws, regulations and systems related to professional health care talents should be strengthened; The development of TCM talents can not correspond with service needs, academic development and industrial development.
3. Development trends of professional health care talents:Economic, social development and demographic changes demanding for professional health care talents will be reinforced; Changes in the health needs request better professional health care talents; Changes in the national priorities require the matching professional health care talents; In2020,10,670,000health personnel are expected to need, of which there are9,144,000health professionals.
4. International experience:Doctors density in China is slightly higher than the global average, but with the big gap with the developed countries; The proportion of doctors to nurses is1:0.85, lower than the global average level (1:2.9); European countries make a variety of different ways to improve the utilization efficiency and effect of health human resources; A reasonable system of higher medical education curriculum is built in other countries; A relatively complete system of general practice life-long education is established in other countries, including higher medical education of general practice (mainly the establishment of compulsory and elective courses), graduate medical education and continuous medical education; Other countries actively take measures for improving rural health manpower shortage.
Suggestions:
1. Implement the "2020Health Talents Reinforce Health Care Project";
2. Classifiedly establish six teams of core professional health care talents;
3. Strengthen the capacity cultivation and development of professional health care talents;
4. Construct research and service platforms of professional health care talents;
5. Increase the investment in the development of professional health care talents;
6. Improve the laws and mechanisms of the management of professional health care talents;
7. Strenthen the development of professional health care talents in medical ethics and medical atmosphere.
为树立“人才资源是第一资源”的意识,建设一支高素质卫生技术人才队伍,确保卫生事业更好地为现代化建设和人民健康服务,根据卫生部《中国2001-2015年卫生人力发展纲要》和《中共中央国务院关于深化医药卫生体制改革的意见》等文件精神,结合我国社会经济及人口状况,以及医药卫生人才队伍建设的实际情况,对我国医药卫生人才队伍建设现状、存在的问题和发展趋势进行系统分析,并详细阐述国际上一些可借鉴的经验,为制定《全国人才队伍建设中长期规划纲要(2009—2020年)》提供科学的决策依据。
方法：
通过文献研究系统梳理医药卫生人才队伍建设的相关理论,以及系统回顾医药卫生人才队伍的相关政策；通过描述性统计学方法,分析我国医药卫生人才的发展现状；运用趋势外推法预测我国卫生人员未来增长趋势；采用专家咨询法验证医药卫生人才队伍发展策略的可行性和可操作性。
结果与结论：
1.我国医药卫生人才队伍建设进展：医药卫生人员总量持续增长,2010年,全国卫生人员总数为820万人,比2005年增加175万人；医药卫生人员结构得到改善,2010年与2005年相比,农村执业(助理)医师所占比例增加1.4个百分点,2010年与2005年相比,西部地区卫生人员和注册护士所占比例分别增加0.2个百分点,2010年与2005年相比,个人办医疗卫生机构卫生技术人员所占比例增加1.6个百分点；医药卫生人员素质能力不断提升,2010年与2005年相比,博士卫生技术人员所占比例增加2.9个百分点,硕士所占比例增加12.7个百分点；医药卫生人才制度规范不断完善。
2.我国医药卫生人才队伍发展面临的问题和挑战：高层次人才队伍建设基础薄弱,2010年,卫生技术人员仍以中专和大专为主,本科及以上学历所占比例仅为24.9%,高级卫生技术人员仅占7.8%；配置不合理,人才短缺与人才过剩并存,2010年,城乡每千人口卫生技术人员数分别为7.62人和3.04人,城市是农村的2.5倍。2010年,东、中、西部地区每千人口卫生技术人员数分别为5.22人、3.93人和3.76人。2010年,医疗机构拥有全国91.1%的卫生技术人员,而疾病预防控制中心仅拥有2.5%。2010年,我国仅有全科医师5.6万人,仅占执业(助理)医师总数的3.5%,远低于国际30%-60%的平均水平。2010年,我国医护比为1：0.85,远低于经合组织国家的比例(1：3.09)；同时,卫生人才难以满足社会快速增长的多层次卫生服务需求；人才培养与社会需求之间存在矛盾；人才队伍管理滞后；人才队伍相关法律法规和制度建设亟待加强；中医药人才队伍建设与服务需求、学术发展、产业发展不相适应。
3.我国医药卫生人才队伍发展趋势：经济、社会发展和人口变化对医药卫生人才需求将进一步增强；健康需求的变化对医药卫生人才队伍提出了更高的要求；国家工作重点的转变要求与之匹配的医药卫生人才队伍；到2020年,预计需要卫生人员1067.0万人,其中卫生技术人员914.4万人。
4.国际经验：我国医生密度略高于全球平均水平,但是与发达国家相比差距较大；中国的医护比为1：0.85,低于全球平均水平(1：2.9)；欧洲各国寻求各种不同的方式来改善卫生人力资源的利用效率与效果；其他国家构建了合理的高等医学教育学制体系；其他国家建立了比较完善的全科医学终生教育体系,包括全科医学的高等医学院校教育(主要是设立必修课和选修课)、毕业后医学教育和继续医学教育；其他国家积极采取改善农村卫生人力不足的措施。
建议：
1.实施“2020人才强卫工程”
2.分类建设六支核心医药卫生人才队伍；
3.加强医药卫生人才的能力培养与开发；
4.构筑医药卫生人才的研究和服务平台；
5.加大医药卫生人才队伍建设的投入力度；
6.完善医药卫生人才管理的法律和机制；
7.促进医药卫生人才的医德医风建设。
Objective:
To provide a scientific basis of decision-making for "Middle and Long-term Development Program of the Talents in China(2009-2020)", set up a the sense of "human resource is the first resource", establish a team of high-quality professional health care talents, and ensure that health care better services the modernization and people's health, according to the spirits of the documents of "Health Manpower Development Program from2001to2015in China" and " Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform", combined the socio-economic and demographic situation in our country, and the actual situation of the establishment of professional health care talents, the paper systematically analyses status quo, problems and development trends of professional health care talents, as well as elaborates a number of useful international experience.
Methods:
Construction theories related to professional health care talents and policies concerning professional health care talents are systematically reviewed through the literature review method; The status quo of professional health care talents is analyzed through the descriptive statistics method; And the future growth trend of professional health care talents is forecasted through rend extrapolation; The feasibility and operability of development strategies of professional health care talents are validated through expert consult method.
Results and Conclusions:
1. Construct development of professional health care talents in China: The total of health personnel continuously increases, and in2010, the total amount of national health personnel was8,200,000, which was1,750,000more than the amount in2005; Health personnel structure has improved, and compared to that in2005, the proportion of rural practitioners (assistant) physicians in2010increased1.4percentage points. Compared to that in2005, the proportion of health personnel and registered nurses in2010in western area in China respectively increased0.2percentage points. Compared to that in2005, the proportion of health professionals in private individuals do medical institutions health technical personnel proportion increased1.6percentage points:The ability and quality of health personnel continuously upgrades, and compared to that in2005, the proportion of health professionals who had doctor degree in2010increased2.9percentage points, the proportion of health professionals who had master degree in2010increased12.7percentage points; Personnel system of health care continuously improves.
2. Problems and challenges faced by the development of professional health care talents in China:Development basis on high-level talent in health care system is weak, and in2010, secondary school and junior college health professionals accounted for the large proportion, and undergraduate and above health professionals accounted for just24.9%, however senior health professionals accounted for only7.8%; Professional health care talents allocation is irrational, and talents shortage and surplus coexist, and the number of health professionals per thousand people in urban in2010was7.62, but that in rural in2010was3.04, and the number of health professionals per thousand people in urban is2.5times more than that in rural. The number of health professionals per thousand people in East, Middle and West in2010was respectively5.22,3.93and3.76. In2010, health professionals in medical institutions accounted for91.1%, however, health professionals in CDC accounted for only2.5%. In2010, the number of general practitioners in China was56,000, which accounted for3.5%of practitioners (assistant) physicians, and lower than the global average level (30%-60%). The proportion of doctors to nurses is1:0.85, lower than the OECD countries average level (1:3.09); Professional health care talents can not meet the demand of the rapid growth and multi-level health service; Professional health care talents training conflicts with social needs; Professional health care talents administration lags behind; Laws, regulations and systems related to professional health care talents should be strengthened; The development of TCM talents can not correspond with service needs, academic development and industrial development.
3. Development trends of professional health care talents:Economic, social development and demographic changes demanding for professional health care talents will be reinforced; Changes in the health needs request better professional health care talents; Changes in the national priorities require the matching professional health care talents; In2020,10,670,000health personnel are expected to need, of which there are9,144,000health professionals.
4. International experience:Doctors density in China is slightly higher than the global average, but with the big gap with the developed countries; The proportion of doctors to nurses is1:0.85, lower than the global average level (1:2.9); European countries make a variety of different ways to improve the utilization efficiency and effect of health human resources; A reasonable system of higher medical education curriculum is built in other countries; A relatively complete system of general practice life-long education is established in other countries, including higher medical education of general practice (mainly the establishment of compulsory and elective courses), graduate medical education and continuous medical education; Other countries actively take measures for improving rural health manpower shortage.
Suggestions:
1. Implement the "2020Health Talents Reinforce Health Care Project";
2. Classifiedly establish six teams of core professional health care talents;
3. Strengthen the capacity cultivation and development of professional health care talents;
4. Construct research and service platforms of professional health care talents;
5. Increase the investment in the development of professional health care talents;
6. Improve the laws and mechanisms of the management of professional health care talents;
7. Strenthen the development of professional health care talents in medical ethics and medical atmosphere.
引文
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