中国全科医学 ›› 2024, Vol. 27 ›› Issue (07): 765-772.DOI: 10.12114/j.issn.1007-9572.2023.0529

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我国全科医生队伍建设十年回望

朱雪波*(), 戴豪杰, 林瑾   

  1. 325035 浙江省温州市,温州医科大学公共卫生与管理学院
  • 收稿日期:2023-09-08 修回日期:2023-09-21 出版日期:2024-03-05 发布日期:2023-12-19
  • 通讯作者: 朱雪波

  • 作者贡献:朱雪波、林瑾负责文章的构思与设计;戴豪杰负责资料收集与整理、结果分析、文章撰写;朱雪波负责文章的质量控制及审校,对文章整体负责;林瑾负责对文章的知识性内容做批评性审阅。
  • 基金资助:
    国家社会科学基金"十三五"规划教育学一般课题(BIA200197)

A Ten-year Retrospective of General Practitioner Team Construction in China

ZHU Xuebo*(), DAI Haojie, LIN Jin   

  1. School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, China
  • Received:2023-09-08 Revised:2023-09-21 Published:2024-03-05 Online:2023-12-19
  • Contact: ZHU Xuebo

摘要: 背景 全科医生是我国在建设初级卫生保健系统和实施"健康中国"战略进程中不可或缺的重要部分,近十年来我国全科医生队伍发展迅猛。 目的 以2012—2022年(近十年)为研究跨度,总结我国全科医生队伍建设的经验成果,分析其存在的困难和不足,为后续我国的全科医生队伍建设提供参考。 方法 借助Donabedian模型,依据SMART原则,选用政策支持、资金投入、基地建设作为结构设计环节的评价指标,从住院医师规范化培训(简称规培)与转岗、中西部全科医生队伍建设两个视角关注过程质量,以队伍规模、结构组成、工作满意度、离职意愿、职业发展机会作为效果评价环节的主要分析维度。研究资料主要源于中国政府网站、中国知网及2012—2022年卫生健康统计年鉴,中国政府网站和中国知网的检索时限设置为2012-01-01—2022-12-31。 结果 近十年我国全科医生队伍建设结构设计不断优化完善,资金投入、基地建设等配套措施紧密落实;过程环节政策端以动态调整回应现实需要,规培与转岗相关制度规范性稳步提高,中西部地区全科医生队伍建设逐年加强;队伍建设效果的区域差异尚存,部分问题尚待解决。 结论 现有全科医生人力资源统计数据无法准确衡量我国全科医生队伍的人力供给情况,队伍稳定性建设有待进一步完善,差异的统筹协调相关研究有待深入。建议持续推进以提升职业吸引力为着力点的全科医生队伍稳定性建设,提高培养、就业、职业发展全周期各环节稳定性,多方合力共促全科医生队伍稳定性达成。

关键词: 全科医生, 卫生人力, 队伍建设, 质量评估, 职业满意, 职业发展, Donabedian模型

Abstract:

Background

General practitioners (GPs) are an indispensable part of primary health care system in China and the implementation of the "Healthy China" strategy. In the past decade, the number of GPs in China has developed rapidly.

Objective

To summarize the experience and achievements of GP team construction from 2012 to 2022 (nearly ten years) , analyze the existing difficulties and deficiencies, and provide reference for the subsequent construction of GP team in China.

Methods

With the help of Donabedian model, policy support, capital investment and base construction were selected as the evaluation indicators of structural design process based on the SMART principle, the process quality was focused from two perspectives of standardized training of residents (referred to as standardized training) and job transfer, the construction of GP team in central and western China. The team size, structure, job satisfaction, resignation intention and career development opportunity were considered as the main analysis dimensions. The data were mainly obtained from Chinese government website and CNKI from 2012-01-01 to 2022-12-31, as well as Health Statistical Yearbook 2012-2022.

Results

In the past decade, the structural design of the construction of GP team in China has been continuously optimized and improved, and the supporting facilities such as capital investment and base construction have been closely implemented. The policy end of process has responded to the practical needs with dynamic adjustments, the standardization of relevant systems for standardized training and job transfer has steadily improved, and the construction of GP team in the central and western regions has been strengthened year by year. Regional differences in the effectiveness of team building still exist, and some problems need to be solved.

Conclusion

Existing human resource statistics on GP cannot accurately measure the human resource supply for GP team in China, and the construction of team stability needs to be further improved. It is recommended to continuously promote the stability construction of the GP team focusing on enhancing career attractiveness, improve the stability of the whole cycle of training, employment and career development, and jointly promote the stability of GP team.

Key words: General practitioners, Health workforce, Team building, Quality assessment, Career satisfaction, Career development, Donabedian model