浙江

发布时间：2018-04-14 12:06

本文选题：分级诊疗 + 卫生人力资源　；参考：《中国卫生政策研究》2017年05期

【摘要】：新医改中,各试点地区对建立分级诊疗制度新模式进行探索实践,其中浙江省实行了以推动城市优质医疗资源下沉和医务人员下基层、提升县域医疗卫生机构服务能力和群众就医满意度(简称"双下沉、两提升")为特色的政策,重点落实"百千万"人才下基层政策,以期填补基层人力资源缺口,提升基层医疗卫生机构服务能力。由于政策具有探索性,政策干预的效果尚不清楚,因此有必要对政策可能产生的影响进行估计。本研究采用系统动力学方法和世界卫生组织的工作负荷法估算分级诊疗模式下医生资源需求量,计算基层医生缺口。采用系统动力学模型仿真"百千万"人才下基层政策效果,并进行敏感性分析。结果显示,基层医生人力资源缺口约为1.4万人。"百千万"人才下基层政策能够逐渐增加基层医生数量,可能在2021年左右填补医生人力缺口。如果医生工作效能提高10%,定向培养就业和基层招聘100%达成政策计划目标,2020年可能填补基层医生缺口。结果显示,该人才政策可能使卫生人力资源结构快速、有效调整,对分级诊疗改革具有一定的促进作用。
[Abstract]:In the new medical reform, the pilot areas have explored and practiced the establishment of a new model of hierarchical diagnosis and treatment system. Among them, Zhejiang Province has implemented a plan to promote the sinking of quality medical resources in cities and the basic level of medical personnel.The policy of promoting the service capacity of the county medical and health institutions and the satisfaction of the masses in seeking medical treatment (referred to as "double sinking, two promotion") is a policy that focuses on the implementation of the "millions" of talented people at the grass-roots level, in order to fill the gap of human resources at the grass-roots level.Improve the service capacity of primary medical and health institutions.Because the policy is exploratory and the effect of policy intervention is not clear, it is necessary to estimate the possible impact of policy.In this study, the system dynamics method and the workload method of the World Health Organization (WHO) were used to estimate the resource requirements of doctors in the graded diagnosis and treatment mode, and to calculate the gap of doctors at the grass-roots level.The system dynamics model is used to simulate the effect of grass-roots policy under "millions" talents, and sensitivity analysis is carried out.The results show that there is a human resource gap of about 14000 doctors at the grassroots level. "The "tens of millions of people" policy will gradually increase the number of doctors at the grass-roots level, possibly filling the workforce gap in 2021 or so.If doctors' work efficiency is improved by 10%, targeted training, employment and grass-roots recruitment reach the policy target of 100%, 2020 may fill the gap of grass-roots doctors.The results showed that this talent policy may make the structure of health human resources quickly and effectively adjust, and promote the reform of classified diagnosis and treatment to a certain extent.
【作者单位】：浙江大学医学院;上海交通大学中国医院发展研究院;
【基金】：国家自然科学基金面上项目(71573229) 浙江省医药卫生科技计划(2014KYA055) 浙江省自然科学基金(LQ14G030009)
【分类号】：R197.1

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