| Objective: To analyze the allocation and balance of high quality health human resources in different regions of Zhejiang Province in 2020,discuss the causes for imbalance phenomenon,and propose strategies and recommendations to optimize the balance of high-educated and high-titled health human resources allocation in Zhejiang Province,providing a reference basis for the development of scientifically reasonable regional health planning.Methods: To make a descriptive analysis of high quality(high-educated,high-titled)health technicians,physicians and registered nurses of municipal-level and county-level in Zhejiang Province(except Hangzhou).The Coefficient of variation,Lorenz curve,and Gini coefficient were used to analyze the balance of health human resources among high-educated and high-titled in different regions of Zhejiang Province.Results: 1.The results of the balance of municipal-level health human resources with high-educated in Zhejiang Province showed that the coefficient of variation of different types of degrees in health technicians per thousand people were: M.D.(CV=0.78),M.M.(CV=0.30),MBBS(CV=0.13);The Gini coefficients were: M.D.(g=0.444),M.M.(g=0.157),and MBBS(g=0.072).The coefficient of variation of different types of degrees in physicians per thousand people were: M.D.(CV=0.80),M.M.(CV=0.31),MBBS(CV=0.13);The Gini coefficients were: M.D.(g=0.457),M.M.(g=0.163),and MBBS(g=0.083).The coefficient of variation of different types of degrees in registered nurses per thousand people were: master and doctor(CV=0.38)and MBBS(CV=0.34);The Gini coefficients were: master and doctor(g=0.218)and MBBS(g=0.150).The Lorenz curve of MBBS health technicians per thousand people,physicians per thousand people were close to the line of perfect equality,followed by M.M.,and the curve of M.D.health technicians,physicians per thousand people were the furthest from the line of perfect equality.The Lorenz curve of MBBS registered nurses per thousand people was close to the line of perfect equality,the master and doctor was further from the line of perfect equality.2.The results of the balance of county-level health human resources with high-educated in Zhejiang Province showed that the coefficient of variation of different types of degrees in health technicians per thousand people were: M.D.(CV=2.48),M.M.(CV=1.29),MBBS(CV=0.52);The Gini coefficients were: M.D.(g=0.798),M.M.(g=0.603),and MBBS(g=0.281).The coefficient of variation of different types of degrees in physicians per thousand people were: M.D.(CV=2.48),M.M.(CV=1.28),MBBS(CV=0.39);the Gini coefficients were: M.D.(g=0.798),M.M.(g=0.602),and MBBS(g=0.210).The coefficient of variation of different types of degrees in registered nurses per thousand people were: master and doctor(CV=1.80)and MBBS(CV=1.06);The Gini coefficients were: master and doctor(g=0.737)and MBBS(g=0.518).The Lorenz curve of M.D.health technicians per thousand people and M.D.physicians per thousand people were furthest from the line of perfect equality,followed by M.M.,and the curve of MBBS was close to the line of perfect equality.The Lorenz curve of MBBS registered nurses per thousand people was closer to the line of perfect equality,the master and doctor was further from the line of perfect equality.3.The results of the balance of municipal-level health human resources with high-titled in Zhejiang Province showed that the coefficient of variation of health technicians with senior professional title,associate senior professional title and intermediate professional title per thousand people were 0.23,0.18 and 0.19;The Gini coefficients were 0.144,0.105 and 0.097.The coefficient of variation of physicians with senior professional title,associate senior professional title and intermediate professional title per thousand people were 0.21,0.13 and 0.13;The Gini coefficients were 0.131,0.086 and 0.071.The coefficient of variation of registered nurses with senior professional title,associate senior professional title and intermediate professional title per thousand people were 0.43,0.27 and 0.27;The Gini coefficients were 0.205,0.141,and 0.123.The Lorenz curve of high-titled health human resources per thousand people were close to the line of perfect equality.4.The results of the balance of county-level health human resources with high-titled in Zhejiang Province showed that the Gini coefficients of health technicians with senior professional title,associate senior professional title and intermediate professional title per thousand people were 0.329,0.240 and 0.216;The Gini coefficients of physicians with senior professional title,associate senior professional title and intermediate professional title per thousand people were 0.316,0.226 and 0.176;The Gini coefficients of registered nurses with senior professional title,associate senior professional title and intermediate professional title per thousand people were 0.396,0.275 and 0.265.The Lorenz curve of high-titled health human resources per thousand people were close to the line of perfect equality.Conclusion: It is found that the balance of high-educated health human resources allocation in Zhejiang Province is poor,with a higher educational level indicating worse balance.The uneven allocation of high-educated health human resources is attributed to the flow of talent to these areas with higher levels of economic and social development,the urban-rural dual structure leading to talent concentration in the main urban areas.On the other hand,the allocation of high-titled health human resources in Zhejiang Province is generally balanced,mainly due to policy reforms in the title evaluation system,improvements in health service capabilities,and the implementation of talent introduction policies tailored to local conditions in various cities.These policies have enabled high-titled health human resources to be deployed at the grassroots level.To achieve the balanced allocation of high-quality health human resources in Zhejiang Province,several recommendations are proposed.Firstly,the training model of "directional training of clinical medical professionals with a master’s degree" can be explored to solve the problem of shortage of high-educated health human resources.Secondly,the enrollment of clinical medical master’s degree programs for equal-level personnel in medical institutions can be expanded to alleviate the imbalanced allocation of health human resources.Thirdly,the enrollment of undergraduate nursing programs should be increased to improve the overall quality of health human resources.Finally,a favorable professional development environment need to be created to attract and retain high-quality health human resources,which is crucial for achieving the balanced allocation of health human resources in Zhejiang Province. |
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