Article(id=1241322671233880869, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202308276, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1692115200000, receivedDateStr=2023-08-16, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773883987482, onlineDateStr=2026-03-19, pubDate=1706112000000, pubDateStr=2024-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773883987482, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773883987482, creator=13701087609, updateTime=1773883987482, updator=13701087609, issue=Issue{id=1241322661654098823, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773883985198, creator=13701087609, updateTime=1773890256678, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241348966214849502, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241348966214849503, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=291, endPage=297, ext={EN=ArticleExt(id=1241322673054208843, articleId=1241322671233880869, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Demand measurement and spatial-temporal pattern of health human resources in maternal and child health institutions in China, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To measure the health human resource demand of maternal and child health institutions in China, and to analyze the spatial and temporal characteristics of maternal and child health human resource allocation.

Methods

The data of health personnel in maternal and child health care institutions from 2018 to 2022 were used, the health human resource density index was used to analyze the change trend of the allocation level of maternal and child health human resources in China from 2017 to 2021, and the actual demand, shortage and proportion of health personnel in maternal and child health institutions in 2021 were calculated. At the same time, global and local spatial autocorrelation was used to explore the spatial characteristics of the allocation level of maternal and child health human resources.

Results

From 2017 to 2021, the density index of health personnel in maternal and child health institutions in China increased year by year, but the LISA diagram showed that the allocation of human resources among provinces was uneven, showing a ’east-west’ differentiation distribution. In 2021, the number of practicing(assistant) physicians per thousand population, registered nurses per thousand population, pharmacists per thousand population and technicians per thousand population in China were 11.30, 14.91, 1.31 and 2.73, respectively, and the ratio of doctors to nurses was 1∶1.32. The Global Moran index and Local Moran index of each health human resource index were greater than 0.

Conclusion

The number of health human resources in maternal and child health institutions in China is increasing, but the inter-regional allocation is not balanced. The internal structure of resource allocation needs to be optimized, and there is obvious spatial aggregation of the same attribute in resource allocation.

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目的

测算全国妇幼保健机构卫生人力资源需求,分析妇幼卫生人力资源配置的时空特征。

方法

采用2018—2022年《中国卫生健康统计年鉴》的妇幼保健机构卫生人员数据,运用卫生人力资源密度指数分析2017—2021年全国妇幼卫生人力资源配置水平的变化趋势,并测算2021年妇幼保健机构卫生人员的实际需要量、缺乏量及缺乏比例;同时运用全局和局部空间自相关探究妇幼卫生人力资源配置水平的空间特征。

结果

2017—2021年,我国妇幼保健机构卫生人员的密度指数逐年增长,但LISA图显示省域间人力资源配置不均,呈“东-西”差异化分布;2021年,我国每千人口执业(助理)医师、每千人口注册护士、每千人口药师(士)及每千人口技师(士)分别为11.30、14.91、1.31、2.73,其中医护比为1∶1.32;各卫生人力资源指标的Global Moran I指数、Local Moran I指数均大于0。

结论

我国妇幼保健机构卫生人力资源数量不断增长,但区域间配置不均衡;资源配置内部结构亟待优化;资源配置存在明显的同属性空间聚集性。

, correspAuthors=null, authorNote=null, correspAuthorsNote=
罗敏,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=mX1X413jHaXxoZOSIErFVg==, magXml=ImLeGzXsAA5hD/IeILG5/w==, pdfUrl=null, pdf=3ok8bjk5V/IXrCDRmmfSfw==, pdfFileSize=827037, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=TbddZfebsUR+WeQs5ozQ1A==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=CjrY9sjL/qZWN4p4bILeEA==, mapNumber=null, authorCompany=null, fund=null, authors=

陈丽君(1997—),女,硕士,研究方向:卫生事业管理

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Chinese Health Service Management, 2022, 39(5): 353-358., articleTitle=Studying on the Spatial-Temporal differentiation of health human resources allocation in China’s disease prevention and control institutions, refAbstract=null)], funds=[Fund(id=1241322683225395675, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, awardId=2023MS216, language=CN, fundingSource=四川省中医药管理局科学技术研究专项课题(2023MS216), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241322674908090384, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, xref=null, ext=[AuthorCompanyExt(id=1241322674912284689, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, companyId=1241322674908090384, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Department of Pediatrics, Chengdu, Sichuan 610045, China), AuthorCompanyExt(id=1241322674924867602, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, companyId=1241322674908090384, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=四川省妇幼保健院/四川省妇女儿童医院/成都医学院附属妇女儿童医院儿科,四川 成都 610045)])], figs=[ArticleFig(id=1241322680109027673, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, language=EN, label=Fig.1, caption=LISA cluster diagram ofhealth human resources in national maternal and child health institutions, figureFileSmall=9AG7FldFusBM3zoR1oe6Dg==, figureFileBig=TbddZfebsUR+WeQs5ozQ1A==, tableContent=null), ArticleFig(id=1241322681648337254, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, language=CN, label=图1, caption=全国妇幼保健机构卫生人力资源LISA聚集图

注:地图源于国家地理信息公共服务平台,审图号为GS(2016)1549;A:卫生技术人员,B:执业(助理)医师,C:注册护士,D:药师(士),E:技师(士)。

, figureFileSmall=9AG7FldFusBM3zoR1oe6Dg==, figureFileBig=TbddZfebsUR+WeQs5ozQ1A==, tableContent=null), ArticleFig(id=1241322682013241731, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, language=EN, label=Table 1, caption=

Time trend of health human resource allocation in national maternal and child health institutions from 2017 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年份每千人口卫生技术人员(人)每千人口执业
(助理)医师(人)
每千人口注册护士(人)每千人口药师
(士)(人)
每千人口技师
(士)(人)
2017年25.279.1111.101.041.84
2018年26.879.6511.951.101.98
2019年28.7710.1513.121.162.11
2020年30.4110.7813.901.222.21
2021年32.2011.3014.911.312.73
年均增长速度4.97%4.38%6.07%4.81%8.18%
), ArticleFig(id=1241322682214568336, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, language=CN, label=表1, caption=

2017—2021年全国妇幼保健机构卫生人力资源配置时间变化趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
年份每千人口卫生技术人员(人)每千人口执业
(助理)医师(人)
每千人口注册护士(人)每千人口药师
(士)(人)
每千人口技师
(士)(人)
2017年25.279.1111.101.041.84
2018年26.879.6511.951.101.98
2019年28.7710.1513.121.162.11
2020年30.4110.7813.901.222.21
2021年32.2011.3014.911.312.73
年均增长速度4.97%4.38%6.07%4.81%8.18%
), ArticleFig(id=1241322682445255064, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, language=EN, label=Table 2, caption=

Health human resource density index of maternal and child health institutions in China from 2017 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)卫生技术人员执业(助理)医师注册护士药师
(士)
技师
(士)
20170.960.350.420.040.07
20181.020.370.460.040.08
20191.100.390.500.040.08
20201.160.410.530.050.08
20211.230.430.570.050.10
), ArticleFig(id=1241322682562695588, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, language=CN, label=表2, caption=

2017—2021年我国妇幼保健机构卫生人力资源密度指数

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)卫生技术人员执业(助理)医师注册护士药师
(士)
技师
(士)
20170.960.350.420.040.07
20181.020.370.460.040.08
20191.100.390.500.040.08
20201.160.410.530.050.08
20211.230.430.570.050.10
), ArticleFig(id=1241322682659164586, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, language=EN, label=Table 3, caption=

Density index, demand, deficiency and proportion of health human resources in maternal and child health institutions in China in 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
省份卫生技术人员执业(助理)医师注册护士
HRDI需要量缺乏量缺乏比例
(%)
HRDI需要量缺乏量缺乏比例
(%)
HRDI需要量缺乏量缺乏比例
(%)
东部1.92114 823-64 103-35.830.7140 280-25 691-38.940.8753 155-27 667-34.23
北京市3.192 330-3 712-61.441.34817-1 718-67.761.291 078-1 365-55.86
天津市0.821 57252049.390.47551-56-9.170.16728520249.78
河北省1.9814 580-8 877-37.840.805 115-4 414-46.320.826 750-2 935-30.31
辽宁省0.469 7276 087167.230.223 4121 67296.110.164 5033 255260.82
上海市2.021 540-992-39.190.79540-451-45.500.93713-453-38.87
江苏省1.9011 486-6 236-35.190.754 029-3005-42.720.845 317-2 529-32.23
浙江省2.6910 213-12 115-54.261.053 583-5 162-59.031.214 728-5 301-52.86
福建省1.598 859-2601-22.690.583 108-1074-25.680.694 101-864-17.40
山东省3.0015 581-22 460-59.041.085 466-8 211-60.041.407 213-10 487-59.25
广东省3.2218 563-30 040-61.811.036 512-9 102-58.291.568 593-14 952-63.50
海南省2.132 333-1 716-42.380.69818-499-37.861.051 080-907-45.64
中部1.22134 9461 5261.140.4447 339-523-0.010.5762 470-194-0.31
山西省1.269 080-244-2.620.483 185-353-9.970.544 2031814.50
吉林省0.778 2033 08660.300.332 87866329.910.313 7971 74685.14
黑龙江省0.5114 9488 763141.690.215 2442735109.010.206 9204 516187.86
安徽省1.1911 3793503.170.473 992-360-8.280.485 26782218.50
江西省2.2310 676-8 695-44.890.763 745-2 870-43.391.104 942-4 584-48.12
河南省2.6915 796-18 774-54.310.915 541-6 120-52.481.297 312-9 286-55.94
湖北省2.2112 800-10 248-44.460.754 490-3 300-42.361.125 926-5 723-49.13
湖南省2.0914 561-10 215-41.230.785 108-4 074-44.371.016 741-5 228-43.68
西部0.99176 26134 41224.260.3261 83216 3330.360.4781 59614 82322.20
内蒙古自治区0.5020 71812 352147.640.207 2683 976120.770.219 5916 088173.79
广西壮族自治区2.5913 451-14894-52.550.784 719-3 811-44.681.296 227-7 907-55.94
重庆市1.666 325-2 225-26.020.522 219-467-17.390.842 928-1 370-31.87
四川省1.3124 801-1 711-6.450.438 700-70-0.790.6411 481-1 519-11.68
贵州省1.8910 129-5 417-34.840.603 553-1 404-28.310.884 689-2 571-35.41
云南省1.4416 714-2 919-14.870.445 863-58-0.980.707 737-1 734-18.31
西藏自治区0.088 2437 7101 446.520.032 8922 7051 446.320.023 8163 6552 270.11
陕西省1.6411 086-3 735-25.200.443 889-114-2.850.715 132-1 248-19.56
甘肃省0.9512 6622 83128.790.324 4421 09832.830.475 8611 01821.03
青海省0.188 0546 868579.060.082 8252 320459.450.063 7283 341863.37
宁夏回族自治区1.502 698-604-18.300.58946-318-25.130.631 249-140-10.09
新疆维吾尔自治区0.2525 52020 296388.520.108 9536 913338.850.0911 8149 867506.78
省份药师(士)技师(士)
HRDI需要量缺乏量缺乏比例
(%)
HRDI需要量缺乏量缺乏比例
(%)
东部0.084 682-3 020-39.210.159 737-4 696-32.54
北京市0.1595-198-67.580.27198-307-60.88
天津市0.04641942.420.091331512.95
河北省0.07595-210-26.140.141 236-455-26.88
辽宁省0.01397288263.900.04825489145.50
上海市0.0863-32-33.910.18131-92-41.45
江苏省0.08468-269-36.450.16974-481-33.06
浙江省0.13416-624-59.960.19866-745-46.24
福建省0.07361-171-32.090.15751-331-30.57
山东省0.12635-828-56.570.251 321-1 863-58.50
广东省0.16757-1 663-68.720.261 574-2 285-59.21
海南省0.0995-68-41.630.19198-171-46.38
中部0.055 5034398.660.1011 443870.77
山西省0.05370226.390.10770486.64
吉林省0.0333414072.420.0669631281.14
黑龙江省0.02610357140.930.041 268752145.67
安徽省0.044646315.710.11965-46-4.56
江西省0.11435-502-53.540.19905-784-46.40
河南省0.10644-592-47.890.241 340-1 750-56.65
湖北省0.07522-231-30.680.181 085-829-43.29
湖南省0.08594-348-36.970.171 235-795-39.17
西部0.047 1881 43324.890.0914 9472 22017.44
内蒙古自治区0.02845467123.500.041 7571 060152.06
广西壮族自治区0.12548-771-58.420.271 141-1 818-61.45
重庆市0.06258-67-20.630.14536-166-23.59
四川省0.061 011-105-9.380.122 103-253-10.73
贵州省0.07413-158-27.660.16859-447-34.23
云南省0.05682-32-4.540.121 417-282-16.58
西藏自治区0.003363091 144.920.016996611 739.49
陕西省0.07452-183-28.810.15940-398-29.74
甘肃省0.0351624489.820.071 07437453.39
青海省0.01328285663.740.01683610835.56
宁夏回族自治区0.07110-46-29.480.13229-65-22.19
新疆维吾尔自治区0.011 041842422.940.032 1641 599283.03
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2021年我国妇幼保健机构卫生人力资源密度指数、需要量、缺乏量及缺乏比例

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省份卫生技术人员执业(助理)医师注册护士
HRDI需要量缺乏量缺乏比例
(%)
HRDI需要量缺乏量缺乏比例
(%)
HRDI需要量缺乏量缺乏比例
(%)
东部1.92114 823-64 103-35.830.7140 280-25 691-38.940.8753 155-27 667-34.23
北京市3.192 330-3 712-61.441.34817-1 718-67.761.291 078-1 365-55.86
天津市0.821 57252049.390.47551-56-9.170.16728520249.78
河北省1.9814 580-8 877-37.840.805 115-4 414-46.320.826 750-2 935-30.31
辽宁省0.469 7276 087167.230.223 4121 67296.110.164 5033 255260.82
上海市2.021 540-992-39.190.79540-451-45.500.93713-453-38.87
江苏省1.9011 486-6 236-35.190.754 029-3005-42.720.845 317-2 529-32.23
浙江省2.6910 213-12 115-54.261.053 583-5 162-59.031.214 728-5 301-52.86
福建省1.598 859-2601-22.690.583 108-1074-25.680.694 101-864-17.40
山东省3.0015 581-22 460-59.041.085 466-8 211-60.041.407 213-10 487-59.25
广东省3.2218 563-30 040-61.811.036 512-9 102-58.291.568 593-14 952-63.50
海南省2.132 333-1 716-42.380.69818-499-37.861.051 080-907-45.64
中部1.22134 9461 5261.140.4447 339-523-0.010.5762 470-194-0.31
山西省1.269 080-244-2.620.483 185-353-9.970.544 2031814.50
吉林省0.778 2033 08660.300.332 87866329.910.313 7971 74685.14
黑龙江省0.5114 9488 763141.690.215 2442735109.010.206 9204 516187.86
安徽省1.1911 3793503.170.473 992-360-8.280.485 26782218.50
江西省2.2310 676-8 695-44.890.763 745-2 870-43.391.104 942-4 584-48.12
河南省2.6915 796-18 774-54.310.915 541-6 120-52.481.297 312-9 286-55.94
湖北省2.2112 800-10 248-44.460.754 490-3 300-42.361.125 926-5 723-49.13
湖南省2.0914 561-10 215-41.230.785 108-4 074-44.371.016 741-5 228-43.68
西部0.99176 26134 41224.260.3261 83216 3330.360.4781 59614 82322.20
内蒙古自治区0.5020 71812 352147.640.207 2683 976120.770.219 5916 088173.79
广西壮族自治区2.5913 451-14894-52.550.784 719-3 811-44.681.296 227-7 907-55.94
重庆市1.666 325-2 225-26.020.522 219-467-17.390.842 928-1 370-31.87
四川省1.3124 801-1 711-6.450.438 700-70-0.790.6411 481-1 519-11.68
贵州省1.8910 129-5 417-34.840.603 553-1 404-28.310.884 689-2 571-35.41
云南省1.4416 714-2 919-14.870.445 863-58-0.980.707 737-1 734-18.31
西藏自治区0.088 2437 7101 446.520.032 8922 7051 446.320.023 8163 6552 270.11
陕西省1.6411 086-3 735-25.200.443 889-114-2.850.715 132-1 248-19.56
甘肃省0.9512 6622 83128.790.324 4421 09832.830.475 8611 01821.03
青海省0.188 0546 868579.060.082 8252 320459.450.063 7283 341863.37
宁夏回族自治区1.502 698-604-18.300.58946-318-25.130.631 249-140-10.09
新疆维吾尔自治区0.2525 52020 296388.520.108 9536 913338.850.0911 8149 867506.78
省份药师(士)技师(士)
HRDI需要量缺乏量缺乏比例
(%)
HRDI需要量缺乏量缺乏比例
(%)
东部0.084 682-3 020-39.210.159 737-4 696-32.54
北京市0.1595-198-67.580.27198-307-60.88
天津市0.04641942.420.091331512.95
河北省0.07595-210-26.140.141 236-455-26.88
辽宁省0.01397288263.900.04825489145.50
上海市0.0863-32-33.910.18131-92-41.45
江苏省0.08468-269-36.450.16974-481-33.06
浙江省0.13416-624-59.960.19866-745-46.24
福建省0.07361-171-32.090.15751-331-30.57
山东省0.12635-828-56.570.251 321-1 863-58.50
广东省0.16757-1 663-68.720.261 574-2 285-59.21
海南省0.0995-68-41.630.19198-171-46.38
中部0.055 5034398.660.1011 443870.77
山西省0.05370226.390.10770486.64
吉林省0.0333414072.420.0669631281.14
黑龙江省0.02610357140.930.041 268752145.67
安徽省0.044646315.710.11965-46-4.56
江西省0.11435-502-53.540.19905-784-46.40
河南省0.10644-592-47.890.241 340-1 750-56.65
湖北省0.07522-231-30.680.181 085-829-43.29
湖南省0.08594-348-36.970.171 235-795-39.17
西部0.047 1881 43324.890.0914 9472 22017.44
内蒙古自治区0.02845467123.500.041 7571 060152.06
广西壮族自治区0.12548-771-58.420.271 141-1 818-61.45
重庆市0.06258-67-20.630.14536-166-23.59
四川省0.061 011-105-9.380.122 103-253-10.73
贵州省0.07413-158-27.660.16859-447-34.23
云南省0.05682-32-4.540.121 417-282-16.58
西藏自治区0.003363091 144.920.016996611 739.49
陕西省0.07452-183-28.810.15940-398-29.74
甘肃省0.0351624489.820.071 07437453.39
青海省0.01328285663.740.01683610835.56
宁夏回族自治区0.07110-46-29.480.13229-65-22.19
新疆维吾尔自治区0.011 041842422.940.032 1641 599283.03
), ArticleFig(id=1241322682889851329, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, language=EN, label=Table 4, caption=

Moran I value of health human resources in national maternal and child health institutions

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指标2017年2018年2019年2020年2021年
Moran IPMoran IPMoran IPMoran IPMoran IP
卫生技术人员0.250.010.250.010.240.020.250.010.250.02
执业(助理)医师0.220.030.230.020.210.030.230.020.220.03
注册护士0.270.010.270.010.270.010.280.010.260.01
药师(士)0.240.010.260.010.240.010.250.010.250.01
技师(士)0.300.000.300.000.260.010.290.010.290.00
), ArticleFig(id=1241322683015680457, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322671233880869, language=CN, label=表4, caption=

2017—2021年全国妇幼保健机构卫生人力资源Moran I

, figureFileSmall=null, figureFileBig=null, tableContent=
指标2017年2018年2019年2020年2021年
Moran IPMoran IPMoran IPMoran IPMoran IP
卫生技术人员0.250.010.250.010.240.020.250.010.250.02
执业(助理)医师0.220.030.230.020.210.030.230.020.220.03
注册护士0.270.010.270.010.270.010.280.010.260.01
药师(士)0.240.010.260.010.240.010.250.010.250.01
技师(士)0.300.000.300.000.260.010.290.010.290.00
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全国妇幼保健机构卫生人力资源需求测度及其时空格局研究
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陈丽君 , 赵梓伶 , 刘宇辞 , 李彦霖 , 周天津 , 张嘉文 , 罗敏
现代预防医学 | 卫生政策与管理 2024,51(2): 291-297
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现代预防医学 | 卫生政策与管理 2024, 51(2): 291-297
全国妇幼保健机构卫生人力资源需求测度及其时空格局研究
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陈丽君, 赵梓伶, 刘宇辞, 李彦霖, 周天津, 张嘉文, 罗敏
作者信息
  • 四川省妇幼保健院/四川省妇女儿童医院/成都医学院附属妇女儿童医院儿科,四川 成都 610045
  • 陈丽君(1997—),女,硕士,研究方向:卫生事业管理

通讯作者:

罗敏,E-mail:
Demand measurement and spatial-temporal pattern of health human resources in maternal and child health institutions in China
Li-jun CHEN, Zi-ling ZHAO, Yu-ci LIU, Yan-lin LI, Tian-jin ZHOU, Jia-wen ZHANG, Min LUO
Affiliations
  • Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Department of Pediatrics, Chengdu, Sichuan 610045, China
出版时间: 2024-01-25 doi: 10.20043/j.cnki.MPM.202308276
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目的

测算全国妇幼保健机构卫生人力资源需求,分析妇幼卫生人力资源配置的时空特征。

方法

采用2018—2022年《中国卫生健康统计年鉴》的妇幼保健机构卫生人员数据,运用卫生人力资源密度指数分析2017—2021年全国妇幼卫生人力资源配置水平的变化趋势,并测算2021年妇幼保健机构卫生人员的实际需要量、缺乏量及缺乏比例;同时运用全局和局部空间自相关探究妇幼卫生人力资源配置水平的空间特征。

结果

2017—2021年,我国妇幼保健机构卫生人员的密度指数逐年增长,但LISA图显示省域间人力资源配置不均,呈“东-西”差异化分布;2021年,我国每千人口执业(助理)医师、每千人口注册护士、每千人口药师(士)及每千人口技师(士)分别为11.30、14.91、1.31、2.73,其中医护比为1∶1.32;各卫生人力资源指标的Global Moran I指数、Local Moran I指数均大于0。

结论

我国妇幼保健机构卫生人力资源数量不断增长,但区域间配置不均衡;资源配置内部结构亟待优化;资源配置存在明显的同属性空间聚集性。

妇幼保健机构  /  卫生人力资源  /  需求测算  /  时空格局
Objective

To measure the health human resource demand of maternal and child health institutions in China, and to analyze the spatial and temporal characteristics of maternal and child health human resource allocation.

Methods

The data of health personnel in maternal and child health care institutions from 2018 to 2022 were used, the health human resource density index was used to analyze the change trend of the allocation level of maternal and child health human resources in China from 2017 to 2021, and the actual demand, shortage and proportion of health personnel in maternal and child health institutions in 2021 were calculated. At the same time, global and local spatial autocorrelation was used to explore the spatial characteristics of the allocation level of maternal and child health human resources.

Results

From 2017 to 2021, the density index of health personnel in maternal and child health institutions in China increased year by year, but the LISA diagram showed that the allocation of human resources among provinces was uneven, showing a ’east-west’ differentiation distribution. In 2021, the number of practicing(assistant) physicians per thousand population, registered nurses per thousand population, pharmacists per thousand population and technicians per thousand population in China were 11.30, 14.91, 1.31 and 2.73, respectively, and the ratio of doctors to nurses was 1∶1.32. The Global Moran index and Local Moran index of each health human resource index were greater than 0.

Conclusion

The number of health human resources in maternal and child health institutions in China is increasing, but the inter-regional allocation is not balanced. The internal structure of resource allocation needs to be optimized, and there is obvious spatial aggregation of the same attribute in resource allocation.

Maternal and child health institutions  /  Health human resources  /  Demand measurement  /  Space-time pattern
陈丽君, 赵梓伶, 刘宇辞, 李彦霖, 周天津, 张嘉文, 罗敏. 全国妇幼保健机构卫生人力资源需求测度及其时空格局研究. 现代预防医学, 2024 , 51 (2) : 291 -297 . DOI: 10.20043/j.cnki.MPM.202308276
Li-jun CHEN, Zi-ling ZHAO, Yu-ci LIU, Yan-lin LI, Tian-jin ZHOU, Jia-wen ZHANG, Min LUO. Demand measurement and spatial-temporal pattern of health human resources in maternal and child health institutions in China[J]. Modern Preventive Medicine, 2024 , 51 (2) : 291 -297 . DOI: 10.20043/j.cnki.MPM.202308276
我国幅员辽阔,受地理位置、经济水平、交通条件等客观因素的影响,不同省域间妇幼保健机构卫生人力资源分布不均[1]。随着“三孩生育”政策的出台,人们对妇幼保健卫生资源的需求不断增加。因此,政府对此给予高度重视,加大对妇幼卫生的支持力度。已有研究发现,2020年妇幼保健机构卫生技术人员数较2000年增长了近3倍[2]。随着政策的落实,全国妇幼保健机构卫生人力资源配置是否满足当前人们的妇幼保健需求?妇幼人力资源分布不均的问题是否得到改善?理清以上问题对满足人们日益增长和多样化的妇幼保健需求,推动全国妇幼健康事业高质量发展具有重要意义[3]
文献研究显示,卫生人力资源相关研究成果较为丰富,但仍存在以下三点不足:一是已有研究主要聚焦于整个卫生系统层面,针对妇幼保健机构的研究较少。二是以往研究主要采用基尼系数、数据包络分析等方法分析妇幼保健机构卫生人力资源配置的公平性与利用效率[4-6],尚无学者测算全国妇幼保健机构卫生人力资源需求,缺乏基于时间、空间双视角的卫生人力资源配置水平比较分析。三是未针对卫生人力资源配置水平的相互依存关系,各省份与邻近省份的空间异质性进行量化研究及可视化分析。基于此,本研究以2017—2021年为研究区间,以省级行政区划为研究单元,通过卫生人力资源密度指数(Health Resources Density Index,HRDI)、全局和局部空间自相关分析全国妇幼保健机构卫生人力资源需求量及时空格局分布特征,以期为全国优化妇幼保健机构卫生人力资源配置提供参考依据。
参考已有文献,选择全国妇幼保健机构的卫生技术人员、执业 (助理) 医师、注册护士、药师 (士) 、技师 (士) 作为评价内容[3]。妇幼保健机构卫生人员数据来源于2018—2022年《中国卫生健康统计年鉴》,人口数、地理面积来自于 2018—2022 年《中国统计年鉴》。
卫生人力资源密度指数(HRDI)是综合人口因素和地理因素衡量卫生人力资源配置水平的重要指标,对分析我国妇幼保健机构卫生人力资源分布的均衡性具有较强的科学性和实用性[7]。HRDI计算公式[8]为:
其中,标准HRDI为全国妇幼保健机构卫生人力资源密度指数值。
全局空间自相关是指采用Global Moran I指数分析整体的空间分布模式、关联性和显著性[9],数据模型[10]为:
其中,n表示全国省份的数量,XiXj表示ij省的妇幼保健机构卫生人力资源密度指数,表示待分析省份的妇幼保健机构卫生人力资源密度指数,Wij表示Rook邻接准则定义的空间权重二次矩阵。Global Moran I指数取值区间为(-1,1),检验水准取α= 0.05,若Global Moran I指数>0,表示全国妇幼保健机构卫生人力资源配置水平具有空间正相关性,呈趋同聚集的特征;反之则具有空间负相关性,呈趋异聚集的特征;Global Moran I指数=0,表示不存在相关性[10-11]
局部空间自相关分析是指进一步探究各省份与邻近省份的局部交互关系,主要采用Local Moran I指数进行测量[9]。本研究旨在分析我国各省份与邻近省份妇幼保健机构卫生人力资源配置水平的空间异质性,数据模型[12]为:
nXiXjWij的含义与前面相同。Local Moran I指数的检验水准取α=0.05,若Local Moran I指数>0,表示妇幼保健机构卫生人力资源聚集空间差异性小,即该省份卫生人力资源配置水平与邻近省份存在同属性空间聚类现象;反之则表示该省份与邻近省份存在不同属性空间聚类现象。为了更直观地展示各省份妇幼保健机构卫生人力资源聚集差异化程度;本研究借助ArcGIS软件绘制LISA聚集图,以可视化的形式对比空间差异特征。LISA聚集图包括5种类型:高-高型(HH)、高-低型(HL)、低-低型(LL)、低-高型(LH)、无统计意义型(NG)[13]。其中,HH与LL型表示卫生人力资源呈聚集状态,即某省卫生人力资源配置水平与邻近省份均高于(低于)全国平均水平,呈局部正相关;HL与LH型表示卫生人力资源呈交错分布状态,即某省卫生人力资源配置水平高于(低于)全国平均水平,而邻近省份卫生人力资源配置水平低于(高于)全国平均水平,呈局部负相关[14]。文中地图审图号为GS(2016)1549。
2017—2021年,我国妇幼保健机构的每千人口卫生技术人员、每千人口执业(助理)医师、每千人口注册护士、每千人口药师(士)以及每千人口技师(士)数量逐年增加,呈持续上升趋势。其中,每千人口技师(士)的年均增长速度最高,为8.18%;每千人口执业(助理)医师的年均增长速度最低,为4.38%,详见表1
借助HRDI的数学模型,计算我国妇幼保健机构卫生人力资源密度指数。结果显示,2017—2021年我国妇幼保健机构卫生人力资源密度指数呈上升趋势,其中卫生技术人员、执业(助理)医师、注册护士、药师(士)及技师(士)的密度指数增长率分别为28.02%、24.50%、34.87%、27.08%、48.87%,详见表2
通过HRDI的数学模型,计算2021年我国妇幼保健机构卫生人力资源密度指数、实际需要量、缺乏量及缺乏比例,结果如表3所示。从地域来看,我国妇幼保健机构卫生人力资源的缺乏比例最高的为西部地区,其中药师(士)数量缺口最大。中部地区缺乏比例由高至低分别为药师(士)、卫生技术人员、技师(士),注册护士、执业(助理)医师数量冗余。而东部地区妇幼保健机构整体均存在卫生人力资源冗余的现象。从省级来看,西藏自治区的卫生技术人员、执业(助理)医师、注册护士、药师(士)及技师(士)缺乏比例最高,分别为1 446.52%、1 446.32%、2 270.11%、1 144.92%及1 739.49%。
对2017—2021年卫生技术人员、执业(助理)医师、注册护士、药师(士)以及技师(士)数进行Global Moran I指数分析,并进行相关性检验。结果显示,2017—2021年全国妇幼保健机构卫生人力资源各指标的Global Moran I>0,且P<0.05,表示全国妇幼保健机构卫生人力资源配置具有空间正相关性,呈趋同聚集的特征,详见表4
对2021年卫生技术人员、执业(助理)医师、注册护士、药师(士)以及技师(士)密度指数进行Local Moran I指数分析。结果显示,各指标的Local Moran I指数分别为0.18、0.17、0.18、0.17、0.17(P<0.05),说明我国妇幼保健机构卫生人力资源聚集空间差异性小,省份与邻近省份妇幼保健机构卫生人力资源存在同属性空间聚类现象。
LISA聚集图结果显示,卫生技术人员聚集性方面,低-低型集中在西藏、新疆、青海、甘肃、宁夏、吉林;低-高型集中在安徽;高-高型集中在江苏、湖南、江西、福建。执业(助理)医师聚集性方面,低-低型集中在西藏、新疆、青海、甘肃、宁夏、四川、吉林;低-高型集中在安徽、天津;高-高型集中在江苏、江西、福建。注册护士聚集性方面,低-低型集中在新疆、青海、吉林;低-高型集中在安徽;高-高型集中在湖南、江西、福建。药师(士)聚集性方面,低-低型集中在西藏、新疆、青海、吉林;低-高型集中在安徽;高-高型集中在湖南、江西、福建。技师(士)聚集性方面,低-低型集中在西藏、新疆、青海、吉林;低-高型集中在安徽;高-高型集中在湖南、福建。详见图1
结果显示,2017—2021年全国妇幼保健机构卫生人力资源数量及密度指数逐年增加,人力资源综合配置水平不断提升。但我国省域间妇幼保健机构人力资源配置不均,呈“东-西”差异化分布特征。具体而言,东部地区妇幼保健机构整体均存在卫生人力资源冗余的现象,而西部地区妇幼卫生人力资源缺口较大。推测导致我国妇幼卫生人力资源短缺与过剩并存的原因主要包括以下三方面:一是东部地区经济发达,文化教育水平较高,职业发展前景广阔,对妇幼卫生人员具有较强的吸引力[4]。二是经济发达地区财政基础较为雄厚,投入到妇幼卫生人力资源配置的财政资金较多,导致东部地区资源配置水平较高[15]。三是目前卫生人力资源配置以每千人口资源拥有量为标准,较为忽略地理可及性对资源配置的影响[16]。基于此,首先卫生行政部门在制定妇幼卫生人力资源规划时,需融入协同发展理念,兼顾人口、地理因素,科学合理地配置资源。其次,西部地区应依托自身区位优势积极发展社会经济,增强财政实力,同时辅以中央财政的转移支付,促进全国妇幼卫生人力资源均衡配置。最后,统筹整合区域资源,利用“云上妇幼”等妇幼信息资源交流平台,多渠道交流合作,以资源“充足地区”带动“匮乏地区”,推动全国各地妇幼卫生人力资源协调发展。
原卫生部《妇幼保健机构管理办法》规定,妇幼保健机构医护比应达到1:2。而我国妇幼保健机构医护比为1∶1.32,未达到标准要求。尽管2017—2021年注册护士的年均增长速度是执业(助理)医师增速的1.39倍,但仍未达到国家规定标准。推测原因主要是因为卫生行业长期以来存在“重医轻护”的现象,同时护士编制匮乏,工作强度大,缺乏专业发展机会,导致护理人员流动性大[17]。此外,执业(助理)医师数量分别是技师(士)、药师(士)的5.46、8.60倍,全国约1/3的省份缺乏注册护士、技师(士)、药师(士)等特殊性妇幼卫生人员,其中西藏自治区注册护士、技师(士)、药师(士)的缺乏比例甚至高达2 270.11%、1 739.49%、1 144.92%。因此,卫生行政部门应转变仅重视医师发展的守旧观念,及时补充短缺的专业技术人员,优化内部结构,建立合理的人才梯队。同时应提高注册护士、技师(士)、药师(士)等特殊妇幼卫生人员的薪酬待遇,畅通其职称晋升渠道,确保人才队伍的稳定性。
2021年妇幼保健机构各类卫生人员的Global Moran I指数均大于0,说明我国妇幼保健机构卫生人力资源配置水平具有趋同聚集的特征。进一步分析Local Moran I指数、LISA聚集图,发现省份与邻近省份之间存在明显的同属性空间聚集效应。究其原因主要包括以下两个方面:第一,卫生人员分布具有显著的“虹吸效应”[11,18]。已有研究发现,经济发展水平是影响妇幼保健机构卫生人力资源配置水平的重要因素[13],因此我国东南部经济发达省份(福建等)对卫生人员的吸引力较强,呈高-高型聚集特征;而西北部西藏、新疆等省份呈低-低型聚集特征。第二,卫生人员配置存在“空间溢出效应”,即相邻省份卫生人力资源配置水平具有较强的相互影响作用[2,10]。一方面,卫生行政部门在制定卫生人力资源规划时,通常会参考邻近省份的政策;且相邻省份距离较近,便于沟通交流卫生人力资源配置的政策规划经验[2,11]。另一方面,邻近省份经济发展水平、教育资源、政策规划等因素对本地区卫生人员具有同质化影响[19],如福建对江西具有辐射带动作用,二者均呈高-高型聚集特征。据此提出以下建议:一是卫生行政部门应制定西部地区妇幼保健机构卫生人才“扩容”的激励政策,实施安家补贴、职称倾斜等措施,构建人才“引、育、用、留”机制,改善西部地区资源配置水平,最终实现高-高聚集。二是各省份之间应加强政策交流,总结妇幼保健机构卫生人力资源规划经验,学习优秀案例,充分发挥示范效应和辐射效应,提升资源配置水平[13]
  • 四川省中医药管理局科学技术研究专项课题(2023MS216)
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2024年第51卷第2期
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doi: 10.20043/j.cnki.MPM.202308276
  • 接收时间:2023-08-16
  • 首发时间:2026-03-19
  • 出版时间:2024-01-25
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  • 收稿日期:2023-08-16
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四川省中医药管理局科学技术研究专项课题(2023MS216)
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    四川省妇幼保健院/四川省妇女儿童医院/成都医学院附属妇女儿童医院儿科,四川 成都 610045

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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