發(fā)布時間：2018-11-13 07:40

【摘要】：研究背景:農(nóng)村與偏遠地區(qū)衛(wèi)生人力資源不足、分布不均衡已成為亟待解決的全球性衛(wèi)生問題,中國也同樣面臨著衛(wèi)生人力失衡的問題。我國城市與農(nóng)村人口比值不斷縮小,但城市衛(wèi)生人員密度卻遠高于農(nóng)村衛(wèi)生人員密度,且由于區(qū)域經(jīng)濟發(fā)展水平、地域環(huán)境差異等原因,我國西部農(nóng)村地區(qū)衛(wèi)生人力資源短缺問題十分嚴重。因此,根據(jù)中國西部農(nóng)村衛(wèi)生人員的實際需求制定、完善中國西部農(nóng)村衛(wèi)生人力資源政策尤為重要。研究目的:在分析中國西部農(nóng)村衛(wèi)生人力政策的基礎上,將衛(wèi)生人力政策分為教育、管理、財政、個人及專業(yè)支持四個方面,通過對不同省縣鄉(xiāng)各級醫(yī)療機構的衛(wèi)生人員進行滿意度調查,分析衛(wèi)生人員對衛(wèi)生人力政策的滿意度情況,探討可能影響衛(wèi)生人力政策滿意度的原因,為中國西部農(nóng)村衛(wèi)生人力政策的修改與調整提供參考依據(jù)。研究方法:從中國西部11個省按經(jīng)濟發(fā)展水平抽取33個縣的人民醫(yī)院、婦幼保健院、疾病預防控制中心及中醫(yī)院;在已被抽取的縣中按人口規(guī)模大小每個縣抽取3個鄉(xiāng)鎮(zhèn)衛(wèi)生院作為樣本。問卷調查法:利用李克特五點計分法設計衛(wèi)生人力政策滿意度調查問卷,對樣本縣鄉(xiāng)醫(yī)療機構的衛(wèi)生人員進行問卷調查;描述性統(tǒng)計法:對樣本地區(qū)衛(wèi)生人員對衛(wèi)生人力政策的認知與滿意度情況等進行描述性統(tǒng)計;橫向比較法:比較各省不同醫(yī)療機構的衛(wèi)生人員對衛(wèi)生人力政策的滿意度等;單因素分析。研究結果:1.樣本地區(qū)衛(wèi)生人力政策總體認知與滿意度情況:僅有48.50%的衛(wèi)生人員表示了解國家及省內的衛(wèi)生人力政策,其中24.52%的人持滿意態(tài)度,53.41%的人持一般態(tài)度,22.07%的人持不滿意態(tài)度。2.通過對衛(wèi)生人員對衛(wèi)生人力政策滿意度差異分析得出,在樣本縣人民醫(yī)院衛(wèi)生人員的年齡、學歷、醫(yī)生內部執(zhí)業(yè)類別分組間的滿意度分別具有統(tǒng)計學意義(P0.05);縣中醫(yī)院與縣疾控中心衛(wèi)生人員僅性別之間滿意度差異具有統(tǒng)計學意義(P0.05);縣婦幼保健院各組衛(wèi)生人力政策滿意度差異均無統(tǒng)計學意義(P0.05);鄉(xiāng)鎮(zhèn)衛(wèi)生院衛(wèi)生人員的年齡、學歷、醫(yī)生護士分組間滿意度差異均具有統(tǒng)計學意義(P0.05)。3.各省在不同機構之間衛(wèi)生人員的總體滿意度較高(78.57%),但也仍有一部分省衛(wèi)生人員的滿意度相對較低(70.00%)。各省之間各級醫(yī)療機構衛(wèi)生人員的滿意度差異均具有統(tǒng)計學意義(P0.05),同類醫(yī)療機構各省之間的滿意度均值有差異,總的來看廣西壯族自治區(qū)衛(wèi)生人力政策滿意度較低。4.從教育政策來看,52.40%的衛(wèi)生人員肯定培訓的積極作用,且42.98%的衛(wèi)生人員認為培訓機會不足,41.00%的縣疾控中心衛(wèi)生人員參加培訓是為解決實際工作問題,而其他機構則多為提高醫(yī)療水平,且主要存在的問題是缺乏實踐與培訓時間短。在管理政策方面,各機構離職意愿較高,且37.50%的衛(wèi)生人員主要離職原因是工資待遇較差,其次是個人價值實現(xiàn)、競爭機會等。在財政政策方面,高收入的衛(wèi)生人員較少,43.63%的衛(wèi)生人員工資在2000-2999元之間;54.14%的人對單位內部收入表示滿意,42.85%的人在與同地區(qū)同級別其他醫(yī)療機構收入相比時表示滿意;在單位激勵機制合理性評價中,66.87%的衛(wèi)生人員認為比較合理,但也仍有31.12%的衛(wèi)生人員認為作用不大。在個人及專業(yè)支持方面,69.68%的衛(wèi)生人員對居住條件較滿意,77.86%的衛(wèi)生人員對執(zhí)業(yè)環(huán)境比較滿意,在工作提升機會上縣級醫(yī)療機構的情況好于鄉(xiāng)鎮(zhèn)衛(wèi)生院。建議:1.精準規(guī)劃政策惠及范圍,高效優(yōu)化人力政策內容2.全國各省優(yōu)勢互補,相互借鑒成功經(jīng)驗3.完善農(nóng)村衛(wèi)生人力培訓制度,加強基層人力繼續(xù)教育4.制定區(qū)域衛(wèi)生人力規(guī)劃,構建合理衛(wèi)生人力流動機制5.增加財政投入政策,鼓勵支援農(nóng)村建設6.創(chuàng)造良好個人條件,完善農(nóng)村基礎設施
[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
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R197.1

【參考文獻】

相關期刊論文 前10條

1 陳莉;張光奇;王蕾;李光毅;吳曉蓉;;貴州加強全科醫(yī)生隊伍建設的探索[J];中國衛(wèi)生人才;2016年04期

2 陳云;范艷存;李敏;杜惠峰;李欣華;;內蒙古基層衛(wèi)生人力政策評價[J];醫(yī)學與社會;2015年12期

3 張凌;樊維維;;我國衛(wèi)生政策研究現(xiàn)狀的文獻計量分析[J];信息資源管理學報;2015年04期

4 陳聞佳;姜潤生;喻箴;楊溪;;泰國農(nóng)村衛(wèi)生人力扶持政策對我國的啟示[J];中國社會醫(yī)學雜志;2014年06期

5 柏高原;王耀剛;楊文秀;王琳;崔壯;夏青;;衛(wèi)生資源配置公平性的政策選擇[J];中國衛(wèi)生資源;2014年06期

6 劉鴻宇;李林貴;孫玉鳳;蘇源;;中國西部9省區(qū)衛(wèi)生人力資源文獻及政策梳理分析[J];中國衛(wèi)生事業(yè)管理;2014年05期

7 王敏;丁楊;張俊華;;泰國醫(yī)療衛(wèi)生志愿者體系及其對我國的啟示[J];中國衛(wèi)生人才;2012年10期

8 黃玉珊;曾林淼;李幼平;周新偉;劉鵬;鐘大可;;我國農(nóng)村衛(wèi)生改革政策系統(tǒng)回顧及績效評價研究[J];中國循證醫(yī)學雜志;2012年03期

9 李穎;田疆;張宏;張光鵬;;澳大利亞農(nóng)村和邊遠地區(qū)分級及其在衛(wèi)生政策中的應用[J];中國衛(wèi)生政策研究;2010年09期

10 王心良;蔣劍勇;;農(nóng)村公共品供給農(nóng)民滿意度實證研究——以浙江省為例[J];經(jīng)濟研究導刊;2009年27期

相關重要報紙文章 前1條

1 汪俞佳;;充分認識強基層強人才強全科重要性[N];人民政協(xié)報;2015年

相關博士學位論文 前4條

1 崔霞;我國醫(yī)藥衛(wèi)生人才隊伍發(fā)展策略研究[D];中南大學;2012年

2 董文朝;新疆衛(wèi)生政策研究[D];中央民族大學;2012年

3 謝娟;我國貧困地區(qū)衛(wèi)生人力資源狀況及其開發(fā)策略研究[D];華中科技大學;2010年

4 劉冬梅;衛(wèi)生政策研究成果應用的影響因素研究[D];山東大學;2006年

相關碩士學位論文 前10條

1 張晨;基于農(nóng)戶滿意度的平江縣集體林權制度改革研究[D];中南林業(yè)科技大學;2014年

2 李可冰;新農(nóng)合滿意度影響因素分析[D];西北農(nóng)林科技大學;2014年

3 劉芳華;地方政府公共服務滿意度影響因素的研究[D];華東理工大學;2014年

4 李秀霞;農(nóng)村及偏遠地區(qū)衛(wèi)生人力資源挽留政策的系統(tǒng)評價再評價[D];蘭州大學;2014年

5 姜慧;我國城鄉(xiāng)基本公共服務均等化問題研究[D];山東師范大學;2012年

6 孫沁谷;成都市耕�；鹫叩霓r(nóng)戶滿意度及問題研究[D];四川農(nóng)業(yè)大學;2012年

7 穆得超;衛(wèi)生人力資源優(yōu)先發(fā)展戰(zhàn)略研究[D];天津醫(yī)科大學;2011年

8 陳少鵬;我國重大衛(wèi)生政策對衛(wèi)生人力發(fā)展影響的研究[D];河北醫(yī)科大學;2011年

9 劉景娜;遵化市衛(wèi)生人力資源配置研究[D];華北煤炭醫(yī)學院;2009年

10 申衛(wèi)國;湖南省衛(wèi)生人力資源現(xiàn)狀及對策研究[D];中南大學;2006年

，

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