Investigation And Study On The Human Resources Of Public Hospitals And Township Health Centers In Guangxi" Old Revolutionary Bases,Minority,Frontier And Barren Areas"

ObjectivesThe medical work of" early-liberated, minority nationality, border and poor areas " has its own particularity because of minority nationalities and weak economic foundation.Taking Baise city as an example, this paper uses question survey to learn about the status of health manpower resource in all of public hospitals and township health centers in Baise city. Through analysis and research of relevant data, we thoroughly understand health human resource current situations and find out the main problem existing in the health manpower resources. Then provide evidence and suggestion for the government to make proper decision on health personnel policy and planning for these underdeveloped area, so as to promote the development of health service in these area, effectively solve the difficult problem of expensive medical treatment and the difficulty of getting medical service.MethodsFirst, systematic literature review was conducted to examine the domestic and foreign related research. Second, field survey on the all of public hospitals and township health centers is carried out against the objectives. The data collected through field survey are then analyzed by different types of health resources through methods including comparison, description and induction. Third, the key indicators of the health human resource are used through Gini Coefficiency and Lorenz Curve to analyze and appraise the equity of the health human resource allocation. Meanwhile, Use the doctor daily clinic visits and bed utilization ratio to analyze and appraise the efficiency of the health resources allocation and utilization. Results(1) The data shows that the total number of health workers in the public hospitals was 106,73 in 2013, of which extra-organizational staff accounted for 58.4%. The proportion of managerial staff, health technological personnel(HTP), other technological personnel and workman were 1.88%,78.50%,5.92%,13.70%. The proportion of workman more than the ration 10% required by the standard of Guangxi. The health personnel was relatively young, among which 43.44% were between 21-30 years of age,while among which 27.04% were between 31-40 years of age. Physicians and nurses accounted for 51.69% and 28.93% of the total HTP. The largest proportion of the HTP was 42.4% for people with associate degree, followed by bachelors, which accounted for 35.8%,while only master prepare is 1.7%.According to technical qualifications,only 6.6% of the overall number of HTP is at a senior level. The majority of HTP are only at junior levels(51.1%). The Physician nurse ratio is 1:1.79,which is less than the ration of 1:2 required by the Ministry of Health. From 2011-2013,there were 631 loss personnel, with the rate of 5.91%. Except for the the distribution equity of health personnel resource among regions, The distribution equity of health manpower resource among population and regions didn’t pass the warning line, and the population equity is prior to that of region(2) The data shows that the total number of health workers in the township health centers was 555,0 in 2013, of which extra-organizational staff accounted for 34.8%. The number of health personnel in the township health centers Per thousand agricultural population was 1.64. According to the professional structure, the proportion of managerial staff, health technological personnel(HTP), other technological personnel and workman were 0.4%, 84.3%,3.3%,12.0%. The proportion of workman more than the ration 10% required by the standard of Guangxi. The health personnel were relatively young, among which 38.4% were between21-30years of age,while among which 37.7% were between 31-40 years of age. Physicians and nurses accounted for 30.7% and 27.3% of the total HTP. The largest proportion of the HTP was 45.46% for people with associate degree, followed by secondary degree, which accounted for 44.73%.According to technical qualifications,only 0.02% of the overall number of HTP is at a senior level. The majority of HTP are only at junior levels(55.01%). The Physician nurse ratio is 1:0.89,which is more than the ration of 1:0.87 in Guagnxi,but less than the ration of 1:1 required by the Ministry of Health. From 2011-2013,there were 992 loss HTP, with the rate of 17.87%. The distribution equity of health manpower resource among population and regions didn’t pass the warning line, and the population equity is prior to that of region.(3) All of public hospitals and health centers have taken the reform of Personnel appointment system,while most of them have taken the reform of performance salary mechanism, however their performance appraisal system were ineffective.ConclusionIn Baise the total quantity of health manpower resource of public hospitals and township health centers is insufficient relatively; the size of personnel staffing is not’ enough and the stability of staff is poor;health human resource structure is imbalance while the quality is low which is especially serious in township health centers; the personnel mechanism is not flexible enough, and the performance appraisal system is ineffective.Based on the issues identified above, the following policy recommendations are made out of this study. First, we should carry out suitable district health plan and make further efforts to make the size of personnel staffing reasonable. Furthermore, take some step to increase the number of health care worker and strengthen the work of cultivating in the medical talents,so as to adjust the Professional structure and improve the overall quality of health personnel. At last, It is essential to deepen the reform of personnel system,so as to create a sound human resources management.