Study On The Equity And Shortage Of Pediatricians And Gynecologists In Jiangsu Province Based On The Hypothesis Of Resource Homogeneity

Objective:The study explored the current situation of pediatricians and obstetricians based on the assumption of resource homogeneity,and grasped the situation of maternal and child health institutions and personnel in each city.Analyzed the number,nature and affiliation of maternal and child health institutions,in addition,demographic-geographic dimension fairness and shortage would be included.Finally,made suggestions on the analysis results to improve the dynamic and scientific management of maternal and child health institutions and talents,met the needs of health services for women and children,then achieved access to maternal and child health services to accelerate the construction of Healthy China.Methods:A questionnaire survey was used to collect data from the information system of the Maternal and Child Health Division of the Jiangsu Provincial Health Committee to conduct a study of practicing(assistant)physicians in maternal and child health institutions,pediatricians and obstetricians in various cities.The first was using descriptive statistics to know the number,nature,affiliation,establishment of maternal and child health institutions,besides,demographic characteristics and health service capability were also included.The second was to use HRDI model,Gini coefficient and Theil index to analyze the fairness of each city.Finally,the demand forecasting model was used to measure the number of pediatricians and obstetricians under the standard workload and the actual workload,and compared with the stock,the number of gaps was the shortage.Results:By the end of 2018,there were totally 110 maternal and child health institutions in Jiangsu Province,all of which belong to the same level of health and health administrative departments,67%(50)institutions are full-funded institutions;in terms of team status,Jiangsu Province Pediatric Practitioner(Assistant)Physician There are 5728 people,11794 in obstetrics and gynecology,mainly female physicians,mainly aged between 34 and 54 years old,mostly with a bachelor’s degree,working years are more than 20 years,most of them are intermediate titles and licensed physicians;health service capabilities In terms of pediatrics per thousand children under the age of 14,and obstetrics and gynecology practitioners(assistant)physicians per thousand women aged 15 to 64 in Jiangsu Province,there were 0.52 and 0.40,and there were 3,535,333 and 36,184,400 outpatient and pediatric,the number of discharged patients was 1.031,1.418 million.The fairness analysis showed that in terms of talent resource density,the overall development level of pediatricans(0.0641)and obstetricans(0.1326)in Jiangsu Province was good.According to the Gini coefficient and Lorentz curve,it found that the allocation of women and children in the province was fairer,and the distribution of population was more fair than the distribution of geographical area.Central part of Jiangsu was more fair than southern and northern,besides,combined with the Theil Index,in terms of pediatrics,the differences mainly came from intra-group,and the differences was mainly in the northern areas.In terms of obstetrics,the differences in the distribution of health personnel by population mainly came from the differences between groups,and the difference was mainly in southern Jiangsu.The shortage study showed that the number of pediatricians Jiangsu was 18,300,and the number of obstetrics was 25,900.The average number of doctors in shortage in each city was about 1,404 and 1,991.The regions with the most shortages were Suzhou,Xuzhou and Nanjing,while the lesser were Taizhou,Yangzhou and Zhenjiang.Conclusion:In the context of the"all-round two-child" policy,the distribution of pediatricians and obstetricians was fairly fair according to population,but there were differences between regions.There was a shortage of women and children,the total number of establishments was insufficient,salary and health services were cheaper,and job satisfaction was low.To this end,it was recommended to optimize the planning of regional health talents,formulate new standards for the establishment of women and children’s institutions,reform the salary system and promulgate talent introduction policies,also strengthen talent cultivation and introduction.In addition,using the "Internet&medical consortium" innovative talent management methods,exploring the establishment of a maternity and child specialist alliance,which would consolidate the construction of pediatricians and obstetricians,and promote the development of high-quality healthy Jiangsu.