玉树抗震救灾医疗救援人力资源配置研究
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摘要
近年来地震灾难频发，但抗震救灾医疗救援队的建设还缺乏相应的理论性指导和相对明确的配置标准，而医疗救援人力资源的配置关系到整个医疗救援的效率，并且抗震救灾医疗救援人力资源配置作为组织抗震救灾医疗救援的重要内容，研究其配置要素的特点、方式及规律，对提高抗震救灾医疗救援效率具有重要的意义。
本课题是军队“十一五”科技攻关项目“卫勤力量部署机理与应用研究”（06G052）和全军医药卫生科研基金课题“非战争军事行动卫勤保障理论研究”(09MAI30)的子课题。本研究基于课题组前期军队卫生资源配置、卫勤力量优化部署和非战争军事行动卫勤力量研究的理论基础，以玉树地震医疗救援人力资源配置为对象，从静态到动态，探讨了抗震救灾医疗救援人力资源配置的规律。
研究目的：
本课题是在总课题研究理念指引下，针对玉树抗震救灾医疗救援人力资源配置进行的拓展研究。在前期军队卫生资源配置、卫勤力量优化部署和非战争军事行动卫勤力量的研究基础上，针对玉树地震医疗救援的现实需求，聚焦抗震救灾医疗救援人力资源配置，进行抗震救灾医疗救援人力资源配置理论研究回顾，从而进一步对玉树抗震救灾医疗救援人力资源配置进行从静态到动态的分析研究，以获得医疗救援人力资源配置的各要素特点，形成提高抗震救灾医疗救援人力资源配置的政策建议，辅助抗震救灾医疗救援队的建设。
研究资料：
研究资料来源包括3部分。一是现场调研资料。包括课题组2010年4月赴玉树进行军队玉树抗震救灾卫勤保障现场调研资料，2010年12月赴青海省卫生厅进行国家玉树紧急医疗救援现场调研资料。现场调研的形式包括专家访谈、小型座谈会、问卷调查。调研的对象包括青海省卫生厅、国家卫生部、青海省内支援玉树灾区医院等机构和救援人员。二是搜集整理的各类文件、报表、日志等。包括课题组2010年8月赴国家卫生部应急办搜集的有关国家玉树地震紧急医疗救援的相关文件、资料100余份；从甘肃省卫生厅、陕西省卫生厅、西藏卫生厅等单位搜集的各省支援玉树地震紧急医学救援的报表等资料30余份。三是从各类期刊数据库检索的地震应急医学救援的相关文献资料。
研究方法：
运用文献归纳荟萃对抗震救灾医疗救援人力资源配置的基本理论研究进行回顾，再运用描述性统计分析、对比分析对玉树地震医疗救援人力资源配置进行实证分析。
主要研究结果和结论：
1、抗震救灾医疗救援人力资源配置理论研究回顾：抗震救灾医疗救援人力资源按来源和分布来分类，主是由本地灾区医疗救援人员、区域支援医疗救援人员、战略支援医疗救援人员和战略加强医疗救援人员等4类人员组成。医疗救援人力资源配置包含总量、结构和分布三个内容，依据抗震救灾各阶段的任务特点，结合抗震救灾医疗救援人力资源配置从静态到动态的变化规律，对医疗救援人力资源进行合理配置。
2、玉树地震医疗救援人力资源配置研究：对本地灾区医疗救援人员、区域支援医疗救援人员、战略支援医疗救援人员和战略加强医疗救援人员的内部结构进行了描述分析，并进一步对不同来源、不同展开位置的医疗救援人员内部结构配置进行了比较分析，总结了不同的救援任务，各级各类医疗救援人员在年龄、男女比例、专业构成、医疗学科构成、学历和职称构成上的不同特征。
3、玉树灾区医疗救援人力资源配置时序分析:以玉树地震发生后医疗救援的时间序列为主线，从横向和纵向分析了每天在玉树灾区展开医疗救治工作的全体医疗救援人员、区域支援医疗救援人员和战略支援医疗救援人员的内部结构配置情况，发现玉树地震后高水平的医疗救援人员在早期就已快速进入灾区展开了救治工作。明确提出了各级各类医疗救援人员在后期因灾区伤员需求的变换，内外科人员的需求将出现转换。进一步强调了抗震救灾医疗救援人力资源配置的特殊性。
4、政策建议：通过上述的研究分析，从抗震救灾医疗救援人才储备库的建设、人力资源的合理配置、医疗人员专业学科的灵活调配和民众基础急救知识的广泛普及等四个方面提出政策建议。
本研究在抗震救灾医疗救援人力资源配置理论研究回顾的基础上，以玉树地震医疗救援作为实证分析，针对医疗救援人力资源总量、结构、分布进行了系统分析，发现其内在特征和规律。本研究是抗震救灾医疗救援人力资源配置的首次尝试，在今后研究中，需进一步深入，使其能够更加实际的为医学救援力量建设提出建议。
Backgrounds:
In recent years, we witness the increasing frequency of earthquake disaster,however, the construction of theoretical guidance and relative team configurationstandard of earthquake relief medical relief forces still far from satisfied. The teamconfiguration of medical relief forces relates to the efficiency of medical rescue effort.As its essential role played in disaster medical rescue effort,study characteristics,methods and laws of the configuration elements of great significance to improve theefficiency of earthquake relief medical aid.
This issue a sub-study of military "11th Five-Year" scientific and technologicalproject "health service force deployment mechanism and applied research"(06G052)and army medical and health research fund subject of theoretical studies of non-warmilitary medical support the (09MAI30). In this study, Based upon the theory ofhealth resources allocation, sample-forming optimization of mobile military medicalunit and science of health service in military operations other than war, the studywould lucubrate the theory of team configuration of medical relief forces.
Objective
Under the direction of main subject, the study is an further exploration on teamconfiguration of medical relief forces of Yushu earthquake. Based on the formerresearch of optimal decision-making of military logistic, sample-forming optimizationof mobile military medical unit and science of health service in military operationsother than war, the study focus on the authentic needs of Yushu earthquake medicalrelieve mission on team configuration of medical relief forces. The whole study hasbeen organized as follow: starts with retrospective study and status analysis on teamconfiguration of medical relief forces in order to draw out the characters of teamconfiguration of medical relief forces, then come up with policy proposal for furtherdevelopment of the construction of disaster medical relief team which supposed toassist the construction of the emergency medical relief forces
Research material
1. Site data, includes enormous questionnaires collected from Yushu by researchteam in April2010, field research material conducted by Qinghai Administration ofHealth in Dec.2010. Expert interview, focus group discussion, and questionnaire havebeen employed during the site data research. Qinghai health bureau, national ministryof health and members of medical relief forces are respondents.
2. Various kinds of report, forms and logs. More than a hundred governmentdocuments form national ministry of health, about thirty form Qinghai health bureaucollected in Aug.2010have been read and checked carefully.
3. Articles form Data base of journal relevant to The team configuration ofmedical relief forces.
Methods
Literature review is employed to define the conception of team configuration ofmedical relief forces. The use of descriptive statistical analysis, comparative analysisof the empirical analysis on the allocation of human resources of the Yushuearthquake medical relief.
Main result and conclusions
Overviews concerning team configuration of medical relief forces: according tothe sources and allocation of primary human resources for emergency medical relieveteam. The rescue power consists of local forces, regional medical rescue supportpower, strategic support powers, strategic strengthen powers. The optimal teamconfiguration should act in line with rescue mission characteristics.
Yushu team configuration of medical relief forces: the characters of Yunshu teamconfiguration referring member numbers, location, time of stay, would be presentedthrough the analysis of deployment and inner structure of Yushu medical relief team,which has great significance of number of receiving patients. The internal structure ofmedical relief forces personnel is differed from types.
Time series analysis of earthquake medical relief of Yushu: Along with the timeseries of medical relief after Yushu earthquake, the construction analyses of whole force, field force and area force is induced form2aspect, vertical and horizontal. Theresult stress the particularity of configuration of medical relieve force and theprofessional structure between physician and surgeon should be changing along withthe require transformation of casualties.
Policy suggestion: through above analyses, policy suggestions would be presentfrom the4aspect: member ship construction and configuration of medical relief team,dynamics professional structure and basic first aid skill.
The study explore the influencing factors of configuration of medical relief team,based on the literature review and Yushu empirical analysis, figure out the principleand regulation about the construction of emergency medical relief team. It is the firstattempt to systematically analyze the configuration of emergency medical relief force.Further researches are required for more practical suggestion on the subject.
本课题是军队“十一五”科技攻关项目“卫勤力量部署机理与应用研究”（06G052）和全军医药卫生科研基金课题“非战争军事行动卫勤保障理论研究”(09MAI30)的子课题。本研究基于课题组前期军队卫生资源配置、卫勤力量优化部署和非战争军事行动卫勤力量研究的理论基础，以玉树地震医疗救援人力资源配置为对象，从静态到动态，探讨了抗震救灾医疗救援人力资源配置的规律。
研究目的：
本课题是在总课题研究理念指引下，针对玉树抗震救灾医疗救援人力资源配置进行的拓展研究。在前期军队卫生资源配置、卫勤力量优化部署和非战争军事行动卫勤力量的研究基础上，针对玉树地震医疗救援的现实需求，聚焦抗震救灾医疗救援人力资源配置，进行抗震救灾医疗救援人力资源配置理论研究回顾，从而进一步对玉树抗震救灾医疗救援人力资源配置进行从静态到动态的分析研究，以获得医疗救援人力资源配置的各要素特点，形成提高抗震救灾医疗救援人力资源配置的政策建议，辅助抗震救灾医疗救援队的建设。
研究资料：
研究资料来源包括3部分。一是现场调研资料。包括课题组2010年4月赴玉树进行军队玉树抗震救灾卫勤保障现场调研资料，2010年12月赴青海省卫生厅进行国家玉树紧急医疗救援现场调研资料。现场调研的形式包括专家访谈、小型座谈会、问卷调查。调研的对象包括青海省卫生厅、国家卫生部、青海省内支援玉树灾区医院等机构和救援人员。二是搜集整理的各类文件、报表、日志等。包括课题组2010年8月赴国家卫生部应急办搜集的有关国家玉树地震紧急医疗救援的相关文件、资料100余份；从甘肃省卫生厅、陕西省卫生厅、西藏卫生厅等单位搜集的各省支援玉树地震紧急医学救援的报表等资料30余份。三是从各类期刊数据库检索的地震应急医学救援的相关文献资料。
研究方法：
运用文献归纳荟萃对抗震救灾医疗救援人力资源配置的基本理论研究进行回顾，再运用描述性统计分析、对比分析对玉树地震医疗救援人力资源配置进行实证分析。
主要研究结果和结论：
1、抗震救灾医疗救援人力资源配置理论研究回顾：抗震救灾医疗救援人力资源按来源和分布来分类，主是由本地灾区医疗救援人员、区域支援医疗救援人员、战略支援医疗救援人员和战略加强医疗救援人员等4类人员组成。医疗救援人力资源配置包含总量、结构和分布三个内容，依据抗震救灾各阶段的任务特点，结合抗震救灾医疗救援人力资源配置从静态到动态的变化规律，对医疗救援人力资源进行合理配置。
2、玉树地震医疗救援人力资源配置研究：对本地灾区医疗救援人员、区域支援医疗救援人员、战略支援医疗救援人员和战略加强医疗救援人员的内部结构进行了描述分析，并进一步对不同来源、不同展开位置的医疗救援人员内部结构配置进行了比较分析，总结了不同的救援任务，各级各类医疗救援人员在年龄、男女比例、专业构成、医疗学科构成、学历和职称构成上的不同特征。
3、玉树灾区医疗救援人力资源配置时序分析:以玉树地震发生后医疗救援的时间序列为主线，从横向和纵向分析了每天在玉树灾区展开医疗救治工作的全体医疗救援人员、区域支援医疗救援人员和战略支援医疗救援人员的内部结构配置情况，发现玉树地震后高水平的医疗救援人员在早期就已快速进入灾区展开了救治工作。明确提出了各级各类医疗救援人员在后期因灾区伤员需求的变换，内外科人员的需求将出现转换。进一步强调了抗震救灾医疗救援人力资源配置的特殊性。
4、政策建议：通过上述的研究分析，从抗震救灾医疗救援人才储备库的建设、人力资源的合理配置、医疗人员专业学科的灵活调配和民众基础急救知识的广泛普及等四个方面提出政策建议。
本研究在抗震救灾医疗救援人力资源配置理论研究回顾的基础上，以玉树地震医疗救援作为实证分析，针对医疗救援人力资源总量、结构、分布进行了系统分析，发现其内在特征和规律。本研究是抗震救灾医疗救援人力资源配置的首次尝试，在今后研究中，需进一步深入，使其能够更加实际的为医学救援力量建设提出建议。
Backgrounds:
In recent years, we witness the increasing frequency of earthquake disaster,however, the construction of theoretical guidance and relative team configurationstandard of earthquake relief medical relief forces still far from satisfied. The teamconfiguration of medical relief forces relates to the efficiency of medical rescue effort.As its essential role played in disaster medical rescue effort,study characteristics,methods and laws of the configuration elements of great significance to improve theefficiency of earthquake relief medical aid.
This issue a sub-study of military "11th Five-Year" scientific and technologicalproject "health service force deployment mechanism and applied research"(06G052)and army medical and health research fund subject of theoretical studies of non-warmilitary medical support the (09MAI30). In this study, Based upon the theory ofhealth resources allocation, sample-forming optimization of mobile military medicalunit and science of health service in military operations other than war, the studywould lucubrate the theory of team configuration of medical relief forces.
Objective
Under the direction of main subject, the study is an further exploration on teamconfiguration of medical relief forces of Yushu earthquake. Based on the formerresearch of optimal decision-making of military logistic, sample-forming optimizationof mobile military medical unit and science of health service in military operationsother than war, the study focus on the authentic needs of Yushu earthquake medicalrelieve mission on team configuration of medical relief forces. The whole study hasbeen organized as follow: starts with retrospective study and status analysis on teamconfiguration of medical relief forces in order to draw out the characters of teamconfiguration of medical relief forces, then come up with policy proposal for furtherdevelopment of the construction of disaster medical relief team which supposed toassist the construction of the emergency medical relief forces
Research material
1. Site data, includes enormous questionnaires collected from Yushu by researchteam in April2010, field research material conducted by Qinghai Administration ofHealth in Dec.2010. Expert interview, focus group discussion, and questionnaire havebeen employed during the site data research. Qinghai health bureau, national ministryof health and members of medical relief forces are respondents.
2. Various kinds of report, forms and logs. More than a hundred governmentdocuments form national ministry of health, about thirty form Qinghai health bureaucollected in Aug.2010have been read and checked carefully.
3. Articles form Data base of journal relevant to The team configuration ofmedical relief forces.
Methods
Literature review is employed to define the conception of team configuration ofmedical relief forces. The use of descriptive statistical analysis, comparative analysisof the empirical analysis on the allocation of human resources of the Yushuearthquake medical relief.
Main result and conclusions
Overviews concerning team configuration of medical relief forces: according tothe sources and allocation of primary human resources for emergency medical relieveteam. The rescue power consists of local forces, regional medical rescue supportpower, strategic support powers, strategic strengthen powers. The optimal teamconfiguration should act in line with rescue mission characteristics.
Yushu team configuration of medical relief forces: the characters of Yunshu teamconfiguration referring member numbers, location, time of stay, would be presentedthrough the analysis of deployment and inner structure of Yushu medical relief team,which has great significance of number of receiving patients. The internal structure ofmedical relief forces personnel is differed from types.
Time series analysis of earthquake medical relief of Yushu: Along with the timeseries of medical relief after Yushu earthquake, the construction analyses of whole force, field force and area force is induced form2aspect, vertical and horizontal. Theresult stress the particularity of configuration of medical relieve force and theprofessional structure between physician and surgeon should be changing along withthe require transformation of casualties.
Policy suggestion: through above analyses, policy suggestions would be presentfrom the4aspect: member ship construction and configuration of medical relief team,dynamics professional structure and basic first aid skill.
The study explore the influencing factors of configuration of medical relief team,based on the literature review and Yushu empirical analysis, figure out the principleand regulation about the construction of emergency medical relief team. It is the firstattempt to systematically analyze the configuration of emergency medical relief force.Further researches are required for more practical suggestion on the subject.
引文
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[3]王兴永,王运斗,伍瑞昌, et al.美国国家灾害医疗系统的发展及对我国的启示[J].中国急救复苏与灾害医学杂志,2010,3(193-6.
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[44]韩志海,王海威,钱阳明, et al.从汶川地震灾区疾病谱构成规律分析医疗救援队的组配变化[J].中国急救复苏与灾害医学杂志,2009,4(209-11.
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