Study On The Current Situation Of Pediatrician Resource Allocation And Optimization Strategies

[Purpose]In this study,the current situation of pediatrician resource allocation in Wuhan was combed,and the field investigation of pediatrician allocation in sample medical institutions was conducted.In-depth analysis of the existing problems and reasons for the allocation of pediatrician resources in Wuhan,and proposed improvement strategies to optimize the allocation of pediatrician resources,and provide a reference for a more reasonable regional pediatrician resource allocation plan.[Methods]The literature research method was used to systematically sort out the current situation of pediatrician resource allocation at home and abroad and related research progress.Descriptive statistical analysis was used to analyze the medical institutions,pediatric beds,pediatrician allocation and pediatric medical service provision of pediatric medical services in Wuhan from 2014 to 2018,and the Gini coefficient and Lorentz curve were used to analyze the fairness of the distribution of pediatricians in Wuhan.Using the stratified sampling method,8 medical institutions(5 third-level medical institutions A,D and E are general hospitals,B and C are specialized hospitals;3 second-level and below medical institutions F and G are general hospitals,and H is a community medical institution)providing pediatric medical services were selected as the research sample,and field investigations were conducted and 78 key insiders were interviewed.Collect qualitative and quantitative data on the number of pediatric doctors,physician team structure,workload status,and talent training status in sample medical institutions from 2014 to 2018,use descriptive statistical analysis and content analysis methods to compare and analyze the differences in pediatrician resources of several sample medical institutions,and explore the dilemmas and problems they face.The grey model GM(1,1)is used to predict the number of children’s resident population in the next 5 years,so as to estimate the needs of pediatricians and analyze the gap.Finally,according to the current situation and problems of resource allocation of pediatricians in Wuhan,the optimization strategy was discussed.[Results]1.Analysis of Pediatric Resources Allocation in WuhanCollected second-hand data on pediatric resource allocation in Wuhan from 2014 to 2018.As of 2018,There are 110 medical institutions providing pediatric diagnosis and treatment services in the city(public medical institutions account for 70% and non-public medical institutions 30%);Among them,there are 50 pediatric inpatient services,of which tertiary hospitals account for 76%;the number of pediatric beds is 4771,accounting for 5% of the total number of beds in the city.The number of pediatric beds was 4,771,accounting for about 5% of the total number of beds in the city.Among them,the number of pediatric beds in tertiary hospitals accounted for 83.4% of the city’s pediatric beds.The number of pediatricians in the city is 1659,the number of pediatricians in the city accounts for 4.2% of the total number of pediatricians in the city,and the pediatricians in tertiary hospitals account for 81.56% of the total number of pediatricians in the city.The number of pediatricians per thousand children was 0.88,and the number of pediatric beds per thousand children was 2.55.Pediatric doctors have a bachelor’s degree and below account for 47%,master’s degree 44%;intermediate and below professional titles account for 72%,of which junior professional titles account for 37%;the overall pediatrician team is younger,the number of people under 44 accounts for 63.7%.Over the past five years,the city’s pediatric beds have increased by an average of 12.8% per year,and the average annual growth rate of pediatricians is 9.9%.The average daily number of outpatients and emergency department attendances of pediatricians is 12.8,and the average number of inpatient bed days per day is 2.9 days,all of which are 1.4-1.5 times higher than the city’s average level.2.Analysis results of pediatrician configuration in sample medical institutionsAmong the five tertiary sample medical institutions,from 2014 to 2018,the number of pediatric outpatient and emergency departments,the number of discharged patients,the number of beds,and the number of doctors all showed an upward trend.Each hospital showed a different degree of increase in each indicator.From the workload point of view,the pediatricians in Hospitals A,B,and C are responsible for outpatient and emergency outpatients and the number of inpatient bed days are far higher than the city’s average.The number of outpatient and emergency outpatients per capita in D hospital is higher than the city’s average,and the outpatient and inpatient workload of pediatricians in hospital E are lower than the city’s average.Except for the small number of pediatricians leaving hospital A,the other four hospitals have high turnover rates.There are no pediatric wards in the three sample medical institutions below the third level,and only routine pediatric outpatient services are provided.In there,Fewer children are treated daily,high turnover rates,few studies and training,and low job satisfaction for pediatricians.3.Wuhan City Pediatrician Predictive Analysis ResultsUsing the gray model GM(1,1)to predict the population of children aged 0-14 in Wuhan from 2019 to 2023.It is predicted that the number of children will be 2.0327 million by 2023,and the population / manpower ratio is predicted.It is predicted that the number of pediatricians per 1,000 children will reach 1.3 by 2023.It can be preliminarily estimated that the pediatrician’s prejudgment result will require 2,642 pediatricians in Wuhan by 2023.[Conclusions]1.Problems in the allocation of pediatrician resourcesBy sorting out the collection of relevant data,the content of insider interviews,and the use of statistical methods,there are a series of problems in the deployment of pediatricians in Wuhan.The pediatrician’s professional title and academic structure are unreasonable,the team of doctors is younger,the pediatrician training mechanism is not perfect,the workload is heavy,the treatment is low,the job satisfaction is low,and the loss is serious.There are obvious gaps in the configuration of pediatricians,and the distribution is seriously uneven.The distribution of pediatric medical resources in the city is concentrated in specialized hospitals,public hospitals,and central urban areas,especially large-scale tertiary Grade A general hospitals and children’s specialized hospitals.The following medical institutions lack pediatricians,and pediatric development tends to shrink.2.Improving strategies for pediatrician resource allocationBased on policy guidance,strengthen the introduction of talents for pediatric doctors at all levels,expand the recruitment scale and channels,strengthen the training of pediatric doctors,and establish a training model for pediatric medical students;adjust the resource layout of pediatricians in the city,give full play to the platform resources of the medical unit and pediatric medical alliance,and sink high-quality pediatric resources;strengthen the implementation of the pediatric grading diagnosis and treatment system,improve the efficiency of pediatric resource utilization;establish a pediatric resource allocation evaluation system,and increase pediatric service pricing.From the perspective of internal management of medical institutions,increase investment in the construction of pediatrics,improve the practice environment of pediatricians,and strengthen the cultivation of the comprehensive quality of pediatricians.Strengthen the cultivation of pediatricians’ comprehensive quality and ability,and innovate the performance distribution method to reflect their labor value,and improve the quality and level of pediatric medical services and highlight the social value of pediatricians.