中国全科医学 ›› 2025, Vol. 28 ›› Issue (28): 3507-3511.DOI: 10.12114/j.issn.1007-9572.2024.0110

• 论著·基层医疗资源配置研究 • 上一篇    下一篇

人口老龄化背景下我国老年全科医生人力资源配置公平性研究

梁振宁, 周清平, 刘涵月, 詹胜帆, 于瑶, 钱怡*()   

  1. 510515 广东省广州市,南方医科大学卫生管理学院
  • 收稿日期:2024-08-18 修回日期:2025-03-14 出版日期:2025-10-05 发布日期:2025-08-28
  • 通讯作者: 钱怡

  • 作者贡献:

    梁振宁提出主要研究目标,负责研究的构思和设计、研究的实施、数据的收集与整理,撰写论文;周清平、刘涵月负责统计学处理,图、表的绘制及展示;詹胜帆、于瑶进行论文的修订;钱怡负责文章的质量控制及审查,对文章整体负责,监督管理。

  • 基金资助:
    广东省高校哲学社会科学重点实验室项目(公共卫生政策与评价重点实验室)(2015WSYS0010); 2022年度广东省大学生科技创新培育基金项目(pdjh2022b0108); 2022年度国家级大学生创新创业计划项目(202212121052)

The Fairness of Human Resource Allocation of Geriatric General Practitioners in China under the Background of Population Aging

LIANG Zhenning, ZHOU Qingping, LIU Hanyue, ZHAN Shengfan, YU Yao, QIAN Yi*()   

  1. School of Health Management, Southern Medical University, Guangdong 510515, China
  • Received:2024-08-18 Revised:2025-03-14 Published:2025-10-05 Online:2025-08-28
  • Contact: QIAN Yi

摘要: 背景 我国自1999年进入老龄化社会,呈现增速快、基数大、未富先老的特征。老龄化加剧对养老体系形成挑战,实施老年健康管理成为科学应对策略。全科医生作为基层医疗守门人,在开展老年健康管理、落实"大健康"理念中发挥核心作用,是应对老龄化挑战的主力军。 目的 探讨2012—2021年中国老年全科医生人力资源配置的地域分布动态及其公平性差异,并分析影响人力资源配置水平的因素,以期为政府制定科学的老年人力资源配置政策提供参考。 方法 本研究通过收集来自2013—2022年《中国统计年鉴》和《中国卫生健康统计年鉴》的相关数据,计算基于总人口和老年人口分布的全科医生基尼系数与泰尔指数的变化趋势,评估老年全科医生人力资源配置的公平性,并构建各个省份全科医学人力资源配置水平的面板双向固定效应模型。 结果 2012—2021年全科医生总数增长了325 074人,各省份全科医生数均实现了不同程度的增长。每万老年人口全科医生数达21.66人,基尼系数由0.38下降至0.33。总泰尔指数、组间和组内泰尔指数均有所下降。面板双向固定效应模型分析结果显示,卫生资源中护士数负向、床位数和执业医师数正向影响显著;人口总量与老龄化率呈正向关联;公路密度负向影响资源配置;而经济发展水平、教育指标及门诊服务量未呈现显著作用。 结论 2012—2021年我国老年全科医生人力资源配置水平持续发展,且公平性不断改善。基于这一趋势,政府在规划全科医生人力资源配置时,应全面考虑包括老龄化率在内的多种因素,以实现更为科学和合理的资源配置。

关键词: 健康老龄化, 人口老龄化, 全科医生, 卫生资源配置, 老年人, 公平性

Abstract:

Background

China entered an aging society in 1999, characterized by rapid growth rate, large population base, and the distinctive pattern of "aging before affluence". The intensifying aging trend poses significant challenges to the pension system, making the implementation of elderly health management a scientifically sound response strategy. As gatekeepers of primary healthcare, general practitioners play a pivotal role in advancing elderly health management and implementing the "comprehensive health management" philosophy, serving as the primary force in addressing aging-related challenges.

Objective

This study investigated the dynamic geographical distribution and equity disparities in the allocation of geriatric general practitioner human resources across China from 2012 to 2021, while analyzing the influencing factors of human resource allocation levels. The findings aim to provide evidence-based references for policymakers to formulate scientific human resource allocation strategies for elderly healthcare services.

Methods

This study collected relevant data from the China Statistical Yearbook and China Health Statistics Yearbook spanning 2013 to 2022. By calculating the changing trends of Gini coefficients and Theil indices based on the total and elderly population distributions, we assessed the equity in human resource allocation of geriatric general practitioners. Furthermore, a two-way fixed effects panel model was constructed to examine the province-level allocation of general practice human resources across various regions.

Results

During the period from 2012 to 2021, the total number of general practitioners in China increased by 325 074, with all provinces demonstrating varying degrees of growth in their general practitioner workforce. The number of general practitioners per 10 000 elderly population reached 21.66, while the Gini coefficient decreased from 0.38 to 0.33. Both the overall Theil index and its inter-group and intra-group components exhibited declining trends. The results of the panel two-way fixed effects model analysis revealed that among healthcare resources: the number of nurses exerted a significant negative effect, whereas bed capacity and licensed physicians demonstrated significant positive effects on resource allocation. Population size and aging rate showed positive associations with resource distribution. Road density exhibited a negative impact on resource allocation. However, economic development level, educational indicators, and outpatient service volume did not exhibit statistically significant effects.

Conclusion

From 2012 to 2021, China witnessed sustained development in the allocation of human resources for geriatric general practitioners, accompanied by progressive improvements in equity. Given this trend, policymakers should holistically consider multiple factors—including population aging rates—when formulating workforce allocation strategies for general practitioners, to achieve more scientifically grounded and rational resource distribution.

Key words: Healthy aging, Population ageing, General practitioners, Elderly, Allocation of health resources, Fairness

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