The Research Of Township Hospital Human Resource Development Strategy In Eastern Regions

[Objective]On the basis of township hospitals human resource development which have been done at home and abroad, a set of proposed suggestions about township hospitals human resource development of the eastern region in our country are going to be put forward. Literature review, system analysis methods, typical regional surveys and other research methods will be applied in this research to improve the development of health services township hospitals.[Methods](1) Literature research. To collect research data of primary health services of human resources development at home and abroad through search engine, including CNKI, Wanfang, Google Scholar, WHO and relevant official websites. Besides, the National Health Services Survey data have been used.(2) Typical region investigation. The research have selected two eastern provinces, ie Zhejiang and Jiangsu, each province selected 2 counties, and each county select 6-7 township hospitals, which issued a questionnaire, and select two township hospitals in each province(one center township hospital, and one general township hospital) to conduct field investigations. By collecting 27 township hospitals relevant data, we acquired the changes of township hospital human resource development in 2009-2013.(3) Focus group interviews. To grasp the operation of eastern township hospitals development situation, human resource allocations, township hospitals personnel system, performance evaluation and relevant incentive factors of human resources development, according to focus group interviews among health administrators, deputy superintendent in charge of medical, public health, and human resources, as well as doctors, nurses and public health practitioners.[Results](1) The questions of the health human resource allocation are as follows: First, the number of human resources allocation is higher than the national average, but still cannot meet the needs of rural residents in the eastern region. The number of agricultural workers per thousand hospitals in the eastern region is higher than the national average level: in eastern region, the number were 1.80 and 1.89 in 2009 and 2014, far above the national average of 1.28 and 1.43 over the same period; health technicians in township hospitals are not high quality, the proportion of secondary school degree or below is over 40% which cannot meet residents' needs resulting the tendency to higher health agencies. Second, authorized strength in center township hospitals is insufficient, while in general ones are vacant. Center township hospitals' authorized strengthes are almost full and more authorized strengthes are needed, while general township hospitals' authorized strengthes are vacant.(2) The questions of health human resource management are as follows: First, Current deployment and authorized strength system brings obstacles to the development of the eastern region of township hospitals. Township hospital personnel deployment and authorized strength system is attributed to County Personnel Management. The financial allocation is on the principle of the anthorized strength number, which brings negative excitation effect. Second, performance evaluation system reduced enthusiasm of township hospital medical staff. In the survey among the medical staff, the proportion which think the performance bring pressure is generally accounted for 43.2%, believe that reward and punishment bring pressure is generally accounted for 44%, 70.5% of the medical staff' most desire is to improve their personal income. Third, Promotion and staff training system limits the township hospital human resource development. The proportion of staff received on-the-job training within two years is 33.8%, the proportion of staff got promotion within two years is 7.5%. Difficult job promotion and differential payment in township hospitals have become a general consensus,.[Conclusions](1) Financing support way should be changed, “checking finance by service” should be introduced to delegate power to township hospitals;(2) Executive Dean of open competition system should be introduced, authorized strength should be recompiled;(3) New technology shares ideas should be introduced in eastern region, the distribution system according to work-based;(4) Some special funds for staff should be conducted for regular training, rural physicians' promotion path should be explored, and efforts to train personnel formal medical education institutions in rural areas should be enhanced.