Study On Allocation Of Health Supervision Manpower Resources In Shenzhen

Objective:To understand the current situation of health supervision manpower resources in Shenzhen, to evaluate the fairness and balance of health supervision manpower resources allocation in Shenzhen, to predict the total number of grassroots health supervisor in the next few years, and to explore the achievements and shortcomings about health supervision manpower resources allocation, so as to provide scientific evidences for the government to conduct health supervision manpower resources planning.Method:We collected all the health supervision manpower resources by questionnaires. The descriptive study was used in analyzing distribution of age, education background, major, and technical title of health supervision manpower resources, and use the data compare with national standards. We utilized Lorenz curve and Gini coefficient to evaluate the fairness of health supervision manpower resources in Shenzhen which according to the population, geographic area, GDP, and object of management distribution. Using the Spearman correlation coefficients to confirm the consistency. We used Health Resources Density Index to evaluate the balance of health supervision manpower resources in Shenzhen. To predict the total number of grassroots health supervisor in the next few years by multiple linear regression model. Using the Semi-structured qualitative interviews and theme-based application framework grounded theory analysis to further explore the amount of Shenzhen health supervisor configuration and its influencing factors. Results:By the end of2013, there were588health inspectors, which include383males, and205females, male to female ratio was1.87:1. The most of health inspectors come from district-level and street-level health supervision institutions, the percentage up to84.35. Health inspectors focused on the age of30～40and40～50, accounting for72.96percent of the city’s total health supervisors. Health inspectors is consisitent in age distribution. Based health supervisors to undergraduate education, the proportion was62.93%, the same as the proportion of graduate students and post-secondary education, approximately16%. Three levels health supervisors was no significant difference (χ2=7.831, P=0.251>0.05). The health inspectors titles constitute a good overall structure, but among all levels of health supervision institutions vary greatly. The difference was statistically significant (χ2=87.109P=0.000). The health inspectors have learned mainly specialized in the medical category, accounting for64.21%, of which a maximum of preventive medicine specialty, the ratio was26.48%. The street-level supervision institutions was most of obvious. The number of preventive medical up to52.73%. According to "health supervision institutions performance appraisal (for Trial Implementation)", the city-level institution has already reached the standard. There have a big difference on staff size in district-level institutions. According to the index about one supervisor/ten thousand resident population. The current gap in the preparation of district-level health supervision institutions total393persons, a large proportion of the gap. It is a good performance in staff using, including the preparation of the Municipal Health Bureau maximum utilization, up to99.11%. The ratio between Health supervisor and staff size have a poor performance, many districts did not reach the standard. The education level generally good in health supervisors, and all the institutions have reached the standard. The grassroots health supervisor’s distribution is fair, but the balance is poor. Shenzhen grassroots health supervisor by the resident population, geographic area, the total GDP, object of management, the Gini coefficient of distribution is:0.257,0.310,0.331,0.226. Grassroots health supervisor presents the polarization trend in balanced, health supervisors highest density index in Longgang District, was0.24, the lowest in Yantian District, was0.01, a difference of24times. The urban adminstration region is better than uraban function region in health supervision accessibility. Using the multiple linear regression model to predict the total number in grassroots health inspectors about2015,2020,2025. The results were543,572,593. Qualitative interviews showed, health supervision manpower resources is still less of total number, especially the inspector for10000persons is a lower proportion. District-level health supervision institutions demand more and more health supervisors. Medical supervisors and occupational health is most scarce. Interviewees generally agreed that staffing is the primary factor affecting the amount of health supervisor configuration.Conclusion:The total is still less than normal in health supervisor in Shenzhen. Does not up to the standard which every million inhabitants with a1to1.5health supervisor. The health inspectors have a good education and title, but the title structure needs to be further optimized. The number of occupational health and medical health inspectors preparing an urgent need to increase. Shenzhen grassroots health supervisor by the resident population, geographic area, the total GDP, the regulatory object, the fairness of the distribution is generally good. Grassroots health supervisor presents polarization trend in balanced. The urban adminstration region is better than urban function region in health supervision accessibility.