Research On Physician Human Capital And Its Equilibrium Under The Health Supply-side Reform In China

As the provider of medical services,physicians are an important part of medical market.As the core competitiveness of medical institution,physician human capital plays a decisive role in the development and performance of hospital.Since the implementation of healthcare system reform in 2009,China has made a lot of remarkable achievements,but the goal of medical reform has not been fully realized,problems like “difficult and expensive to get medical service” still exists for a long time.The unbalanced supply and demand of medical service and the unequal distribution of medical resources have not been fundamentally solved.With the promotion of “Healthy China initiative”,the supply-side reform is radiating to the medical and health fields.Under the background of medical supply-side reform,by analyzing the characteristics of physician human capital,measuring the equilibrium of distribution and its correlation,and exploring the problems and challenges,it provides the practical basis for the effective allocation and development of the physician human capital in China.Based on the physician information from 2012 to 2016 from the information system of medical institutions in Sichuan Province,and the annual report data and statistical yearbook data of hospitals from the health and family planning information center of Sichuan Province,this paper analyzes the supply of physician human capital in Sichuan province to find out the supply,internal structure,distribution structure and its equilibrium of physician human capital under the background of medical supply-side reform.On this basis of using the index of the average years of schooling,Lorentz curve,Gini coefficient and Theil index,this paper analyzes the equilibrium of the distribution of human capital of doctors in Sichuan province.We also used the ordinary least squares to analyzes the factors that may affect the physician human capital.The main results are as follows:(1)There is structural imbalance in the supply of medical students.The growth rate of enrollment of college level medical students is the highest,with an increase of 190.7per cent in 2009-2019,followed by graduate students,with an increase of 108.9 per cent,and a 25.2 per cent decrease in the enrollment of secondary vocational school students.The enrollment of medical college students in Sichuan Province has exceeded that of medical students in this department,but at the same time,the proportion of doctors with college degree has not increased,and it is decreasing year by year.(2)The gender ratio of physicians in Sichuan province has decreased from 1.31 in 2012 to 1.21 in 2016.The sex ratio of physicians in non-profit hospitals decreased from 1.29 to 1.17 in five years,while that in for-profit hospitals increased from 1.41 to 1.45.(3)Most of physicians are aged from 20 to 40 years old,and the proportion of elderly doctors in for-profit hospitals is significantly higher than that in non-profit hospitals.(4)In terms of the supply of physician labor force,the population balance is better than the geographical balance.(5)From 2012 to 2016,the Gini coefficient of physician’s average annual income in each hospital ranged from 0.33 and 0.35,and the total Theil index ranged from 0.18 and 0.21.The performance of the within-group Theil Index is better than the between-group Theil index.(6)Investment of Fixed Assets,total expenditure and the ratio of the number of actual beds to the number of doctors in different types of medical institutions have significant effects on the level of human capital of doctors.According to the above results,we put forward the following suggestions:(1)Improve the standard of entry-level medical education,improve and optimize the physician training system.(2)Strengthen the construction of physician team and promote the integration and coordinated development of physician workforce.(3)Reasonable allocation of medical resources are required to ensure the equilibrium of regional medical service.(4)Establishing a reasonable pricing mechanism of physician human capital to ensure the balance of their income distribution.