Spatial Distribution And Difference Of Health Human Resources Among Provinces In China

Objective: To investigate the mechanism of the disease This paper describes the spatial distribution and change characteristics of the number of health human resources in China from 2008 to 2018,explores the relevant factors affecting the spatiotemporal flow of health human resources in China,and deeply analyzes the spatial dynamic changes of four categories of health personnel(health technicians,licensed doctors,nurses,licensed pharmacists)in health human resources,so as to accelerate the orderly flow of health human resources and promote the development of talents Mobility policy provides scientific evidence.Methods: Moran index was used to calculate the spatial dependence,and the spatial distribution and dynamic change of health human resources in China were described by constructing the spatial weight matrix of health human resources.This paper used the adjacent geospatial weight matrix to construct the spatial econometric model of health human resources,based on which the main influencing factors and spatial effects of health human resources flow in China are analyzed.Results: The total number of health human resources in China increased significantly,from 7.2518 million in 2008 to 12.303 million in 2018,with an average annual growth rate of 5.42%.Specifically:(1)the number of health technical personnel increased from 5.174 million in 2008 to 9.529 million in2018,with an average annual growth rate of 6.74%.The spatial agglomeration of health technical personnel decreased,and the Moran index decreased from0.226 in 2008 to 0.155 in 2018.The spatial agglomeration areas spread from the central region and economically developed regions to the central and western regions.The wage ratio(direct effect 2.66)and per capita investment in Education(direct effect 1.11)are the main factors affecting the inter provincial mobility of health professionals;(2)the number of medical practitioners increased from more than 2.2 million in 2008 to 3.67 million in 2018,with an average annual growth rate of 4.9%.The spatial agglomeration spread from Beijing to coastal cities and central and western cities,and the spatial agglomeration decreased from 0.231 in 2008 to 0.135 in 2018.House price ratio(direct effect 2.43),per capita medical and health expenditure(direct effect 0.28),per capita education investment(direct effect 0.31),population growth(direct effect < 0.01)and beds per thousand population(direct effect 0.38)were the main factors affecting the inter provincial flow of licensed doctors;(3)for nursing staff,the number of nursing staff in 31 provinces increased from 167.8%to 167.8% since 2008 The overall Moran index decreased from 0.182 in 2008 to-0.103 in 2018,and the distribution of personnel spread from point to area,from the economically developed coastal areas to the central region.Wage ratio(indirect effect 1.67),unemployment rate(direct effect-0.17),per capita medical and health expenditure(direct effect 0.42),per capita education resource investment(direct effect 0.67),population growth(direct effect < 0.01)and beds per thousand population(direct effect 0.38)were the influencing factors of the spatial distribution of nursing staff;(4)the number of occupational pharmacists increased from 330000 in 2008 to 460000 in 2018 More than 70000 people,with an average annual growth rate of 2.7%.The overall Moran index decreased from 0.183 in 2008 to 0.068 in 2018,the spatial agglomeration decreased from 0.183 to 0.068,and the change of spatial distribution pattern is not obvious.Unemployment rate(direct effect-0.10),per capita education expenditure(direct effect 0.74)and population growth(direct effect < 0.01)were the main factors affecting the spatial distribution of occupational pharmacists.Conclusion: since the implementation of the new medical reform for 11 years,the shortage of health human resources in China has been significantly improved,and the accessibility of health services has been greatly enhanced.Specifically,the spatial agglomeration effect still exists in some economically developed areas,and the distribution balance of high-quality medical and health resources needs to be strengthened.The growth rate of different types of health personnel is different,the growth rate of health technical personnel is the fastest,and the number of licensed doctors is still in shortage.At the same time,the statistical results show that the income level and education resources are the main factors affecting the flow of health human resources at this stage.We should vigorously increase the investment in education resources in the central and western regions of China.Competitive wages and high-quality education resources can better retain and attract health talents.Thirdly,the influencing factors of different types of health human resources spatial flow are different.Policy makers should think about it pertinently.At the same time,local management departments should consider both the absolute value of resources invested and the relative value of resources invested with surrounding areas when strengthening all kinds of resources investment.It is necessary to further relax the threshold of running hospitals by society,continue to strengthen the construction of medical and health teams at the grass-roots level,issue corresponding guidance,promote the rational flow of high-quality health human resources to the central and western regions,improve the relative fairness of health human resources,and avoid the "siphon effect" of health human resources.