中国西部农村卫生人员对卫生人力资源政策的满意度评价研究
发布时间：2018-11-13 07:40
【摘要】：研究背景:农村与偏远地区卫生人力资源不足、分布不均衡已成为亟待解决的全球性卫生问题,中国也同样面临着卫生人力失衡的问题。我国城市与农村人口比值不断缩小,但城市卫生人员密度却远高于农村卫生人员密度,且由于区域经济发展水平、地域环境差异等原因,我国西部农村地区卫生人力资源短缺问题十分严重。因此,根据中国西部农村卫生人员的实际需求制定、完善中国西部农村卫生人力资源政策尤为重要。研究目的:在分析中国西部农村卫生人力政策的基础上,将卫生人力政策分为教育、管理、财政、个人及专业支持四个方面,通过对不同省县乡各级医疗机构的卫生人员进行满意度调查,分析卫生人员对卫生人力政策的满意度情况,探讨可能影响卫生人力政策满意度的原因,为中国西部农村卫生人力政策的修改与调整提供参考依据。研究方法:从中国西部11个省按经济发展水平抽取33个县的人民医院、妇幼保健院、疾病预防控制中心及中医院;在已被抽取的县中按人口规模大小每个县抽取3个乡镇卫生院作为样本。问卷调查法:利用李克特五点计分法设计卫生人力政策满意度调查问卷,对样本县乡医疗机构的卫生人员进行问卷调查;描述性统计法:对样本地区卫生人员对卫生人力政策的认知与满意度情况等进行描述性统计;横向比较法:比较各省不同医疗机构的卫生人员对卫生人力政策的满意度等;单因素分析。研究结果:1.样本地区卫生人力政策总体认知与满意度情况:仅有48.50%的卫生人员表示了解国家及省内的卫生人力政策,其中24.52%的人持满意态度,53.41%的人持一般态度,22.07%的人持不满意态度。2.通过对卫生人员对卫生人力政策满意度差异分析得出,在样本县人民医院卫生人员的年龄、学历、医生内部执业类别分组间的满意度分别具有统计学意义(P0.05);县中医院与县疾控中心卫生人员仅性别之间满意度差异具有统计学意义(P0.05);县妇幼保健院各组卫生人力政策满意度差异均无统计学意义(P0.05);乡镇卫生院卫生人员的年龄、学历、医生护士分组间满意度差异均具有统计学意义(P0.05)。3.各省在不同机构之间卫生人员的总体满意度较高(78.57%),但也仍有一部分省卫生人员的满意度相对较低(70.00%)。各省之间各级医疗机构卫生人员的满意度差异均具有统计学意义(P0.05),同类医疗机构各省之间的满意度均值有差异,总的来看广西壮族自治区卫生人力政策满意度较低。4.从教育政策来看,52.40%的卫生人员肯定培训的积极作用,且42.98%的卫生人员认为培训机会不足,41.00%的县疾控中心卫生人员参加培训是为解决实际工作问题,而其他机构则多为提高医疗水平,且主要存在的问题是缺乏实践与培训时间短。在管理政策方面,各机构离职意愿较高,且37.50%的卫生人员主要离职原因是工资待遇较差,其次是个人价值实现、竞争机会等。在财政政策方面,高收入的卫生人员较少,43.63%的卫生人员工资在2000-2999元之间;54.14%的人对单位内部收入表示满意,42.85%的人在与同地区同级别其他医疗机构收入相比时表示满意;在单位激励机制合理性评价中,66.87%的卫生人员认为比较合理,但也仍有31.12%的卫生人员认为作用不大。在个人及专业支持方面,69.68%的卫生人员对居住条件较满意,77.86%的卫生人员对执业环境比较满意,在工作提升机会上县级医疗机构的情况好于乡镇卫生院。建议:1.精准规划政策惠及范围,高效优化人力政策内容2.全国各省优势互补,相互借鉴成功经验3.完善农村卫生人力培训制度,加强基层人力继续教育4.制定区域卫生人力规划,构建合理卫生人力流动机制5.增加财政投入政策,鼓励支援农村建设6.创造良好个人条件,完善农村基础设施
[Abstract]:Research background: The shortage of health and human resources in rural and remote areas has become a global health problem to be solved urgently, and China is also facing the problem of the imbalance of health manpower. The ratio of urban and rural population in China is shrinking, but the density of the urban sanitation personnel is much higher than that of the rural health personnel, and the shortage of health and human resources in the western rural areas of China is very serious due to the regional economic development level and the regional environmental difference. Therefore, according to the actual demand of the rural health personnel in the western part of China, it is very important to improve the rural health human resources policy in the western part of China. The purpose of the study is to divide the health manpower policy into four aspects: education, management, finance, personal and professional support based on the analysis of the rural health manpower policy in the western part of China. The paper analyzes the satisfaction of the health personnel to the health manpower policy, and probes into the reasons that may affect the satisfaction of the health manpower policy, and provides a reference for the revision and adjustment of the rural health manpower policy in the western part of China. Methods: The people's hospital, mother and child health care institute, disease prevention control center and middle hospital were taken from 11 provinces in the west of China according to the level of economic development. Methods: The questionnaire of health manpower policy satisfaction survey was designed by using the five-point scoring method of Likert, and the health personnel of the medical institutions of the counties and counties of the samples were investigated by questionnaire. The descriptive statistics method: Descriptive statistics are made on the awareness and satisfaction of the health personnel in the sample area, such as the awareness and satisfaction of the health manpower policy, and the horizontal comparison method: the satisfaction of the health personnel of different medical institutions in the provinces to the health and human policy is compared; and the single-factor analysis. Study Results: 1. The general cognition and satisfaction of the health manpower policy in the sample area: only 48. 50% of the health personnel indicated the national and provincial health manpower policies, of which 24. 52% of the people were satisfied, 53. 41% held the general attitude, and 22. 07% of the people were not satisfied with the attitude. Through the analysis of the difference of the health personnel's satisfaction with the health manpower policy, the degree of satisfaction of the health personnel at the people's hospital in the sample county was statistically significant (P0.05). There was no significant difference in the degree of satisfaction between the health personnel of the county and the county disease control center (P0.05). There was no significant difference in the degree of satisfaction between the health personnel and the health personnel at the county and the county level (P0.05), and the age and the degree of the health personnel in the township health center. The difference of satisfaction among the nurses in the nurses was statistically significant (P0.05). The overall satisfaction of health personnel among the various agencies was high (78. 57%), but there was still a relatively low level of satisfaction in some of the provincial health personnel (70.00%). There was a significant difference in the satisfaction of the health personnel at all levels between the provinces (P0.05). in that light of the education policy, 52. 40% of the health personnel have positive effect on the training, and 42. 98% of the health personnel consider that the training opportunities are insufficient and that 41. 00% of the health personnel of the county disease control centre participate in the training to address the practical problem of work, while the other agencies are increasing the level of medical care, and the main problems are lack of practice and short training time. in that area of management policy, the willingness of the agencies to leave is high, and 37. 50% of the health personnel are mainly due to poor wage treatment, followed by personal value realization, competition opportunity, and the like. In the area of fiscal policy, the high-income health personnel are less, and 43. 63% of the health workers are in the range of 2000-2999 yuan; 54. 14% of the people are satisfied with the internal income of the unit, and 42. 85% of the people are satisfied with the income of other medical institutions at the same level as the same area; In the evaluation of the rationality of the unit's incentive mechanism, 66. 87% of the health personnel think it is reasonable, but there are still 31. 12% of the health personnel think the effect is not big. In the area of personal and professional support, 69. 68% of the health personnel are satisfied with the living conditions, 77. 86% of the health personnel are satisfied with the practice environment, and the situation of the county-level medical institutions at the county level is better than that of the township health center. Recommendation: 1. The policy of precision planning benefits the scope and efficiently optimizes the human policy content 2. The provinces of the whole country have complementary advantages, and learn from each other for reference to the successful experience of 3. Improve the rural health manpower training system, and strengthen the basic level of manpower to continue education. The establishment of the regional health manpower planning and the construction of the rational health manpower flow mechanism 5. To increase the financial investment policy and to encourage the support of rural construction 6. to create good personal conditions and to improve the rural infrastructure
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1
本文编号：2328451
[Abstract]:Research background: The shortage of health and human resources in rural and remote areas has become a global health problem to be solved urgently, and China is also facing the problem of the imbalance of health manpower. The ratio of urban and rural population in China is shrinking, but the density of the urban sanitation personnel is much higher than that of the rural health personnel, and the shortage of health and human resources in the western rural areas of China is very serious due to the regional economic development level and the regional environmental difference. Therefore, according to the actual demand of the rural health personnel in the western part of China, it is very important to improve the rural health human resources policy in the western part of China. The purpose of the study is to divide the health manpower policy into four aspects: education, management, finance, personal and professional support based on the analysis of the rural health manpower policy in the western part of China. The paper analyzes the satisfaction of the health personnel to the health manpower policy, and probes into the reasons that may affect the satisfaction of the health manpower policy, and provides a reference for the revision and adjustment of the rural health manpower policy in the western part of China. Methods: The people's hospital, mother and child health care institute, disease prevention control center and middle hospital were taken from 11 provinces in the west of China according to the level of economic development. Methods: The questionnaire of health manpower policy satisfaction survey was designed by using the five-point scoring method of Likert, and the health personnel of the medical institutions of the counties and counties of the samples were investigated by questionnaire. The descriptive statistics method: Descriptive statistics are made on the awareness and satisfaction of the health personnel in the sample area, such as the awareness and satisfaction of the health manpower policy, and the horizontal comparison method: the satisfaction of the health personnel of different medical institutions in the provinces to the health and human policy is compared; and the single-factor analysis. Study Results: 1. The general cognition and satisfaction of the health manpower policy in the sample area: only 48. 50% of the health personnel indicated the national and provincial health manpower policies, of which 24. 52% of the people were satisfied, 53. 41% held the general attitude, and 22. 07% of the people were not satisfied with the attitude. Through the analysis of the difference of the health personnel's satisfaction with the health manpower policy, the degree of satisfaction of the health personnel at the people's hospital in the sample county was statistically significant (P0.05). There was no significant difference in the degree of satisfaction between the health personnel of the county and the county disease control center (P0.05). There was no significant difference in the degree of satisfaction between the health personnel and the health personnel at the county and the county level (P0.05), and the age and the degree of the health personnel in the township health center. The difference of satisfaction among the nurses in the nurses was statistically significant (P0.05). The overall satisfaction of health personnel among the various agencies was high (78. 57%), but there was still a relatively low level of satisfaction in some of the provincial health personnel (70.00%). There was a significant difference in the satisfaction of the health personnel at all levels between the provinces (P0.05). in that light of the education policy, 52. 40% of the health personnel have positive effect on the training, and 42. 98% of the health personnel consider that the training opportunities are insufficient and that 41. 00% of the health personnel of the county disease control centre participate in the training to address the practical problem of work, while the other agencies are increasing the level of medical care, and the main problems are lack of practice and short training time. in that area of management policy, the willingness of the agencies to leave is high, and 37. 50% of the health personnel are mainly due to poor wage treatment, followed by personal value realization, competition opportunity, and the like. In the area of fiscal policy, the high-income health personnel are less, and 43. 63% of the health workers are in the range of 2000-2999 yuan; 54. 14% of the people are satisfied with the internal income of the unit, and 42. 85% of the people are satisfied with the income of other medical institutions at the same level as the same area; In the evaluation of the rationality of the unit's incentive mechanism, 66. 87% of the health personnel think it is reasonable, but there are still 31. 12% of the health personnel think the effect is not big. In the area of personal and professional support, 69. 68% of the health personnel are satisfied with the living conditions, 77. 86% of the health personnel are satisfied with the practice environment, and the situation of the county-level medical institutions at the county level is better than that of the township health center. Recommendation: 1. The policy of precision planning benefits the scope and efficiently optimizes the human policy content 2. The provinces of the whole country have complementary advantages, and learn from each other for reference to the successful experience of 3. Improve the rural health manpower training system, and strengthen the basic level of manpower to continue education. The establishment of the regional health manpower planning and the construction of the rational health manpower flow mechanism 5. To increase the financial investment policy and to encourage the support of rural construction 6. to create good personal conditions and to improve the rural infrastructure
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1
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