Study On Rational Assignment Of Doctors And Work Ration Standard In Secondary Level Hospitals

Objective: To know the basic status of health manpower in secondary level hospitals by sampling and compare the current work ration with the standard. To explore the standard by analysing the inside and outside factors impacting the work ration, and then to improve the cognition about rational assignment of doctors, providing scientific references and suggestions for the establishment of the in secondary level hospitals.Method: We carve up the western, central and eastern districts according to the standard of the National Bureau of Statistics, take out 1-2 provinces according to the GDP level in each district and investigate the representative secondary level hospitals. We confirm the work ration criterion by expert consultation and the feedback to the hospitals must be further validated. Quantitative researches of real working rations of doctors, out-patient and the ward department doctors'working ration are carried out. Finally, the impact factors on the working rations in secondary level hospitals are analysed using single factor, multi-factor analysis of biological statistical methodsResults and analyses:1. The obvious increase of the actual open beds and equipped manpower reflects the current manpower deficiency, compare with the standard of the year 1978.2. That the gradually increase of the proportion of mid-youth doctors consist with the rational age structure of manpower resource,"olive model". But the irrational"drum model"of doctor structure tends to develop into the"funnel model".3. The actual time spended on diagnosis and treatment is more than the planned, which results in the excess workload of doctors and the questionable service quality especially in surgery, cadre ward, internal medicine, gynecologic and obstetric ward. The graduate students, refresher doctors and practicing students assume a part of work, which releases the conflict, but the essential problem has not be settled.4. The workload of physicians is too great to influence the medical service quality.5. The patients with familiar diseases are switched to the wards,which lead the workload of out-patient department decreasing. It results in the waste of medical resources and the addition of medical burden of the patients.6. The consultation hours of different districts take on"olive model". The health resources should lean to the middle district. The secondary level hospitals of eastern districts should reduce the collocation of out-patient doctors. The hospitals in western districts need more doctors of in-patient department.7. At present, there are much irrational phenomena in doctor amount, professional position and workload. It greatly restricts the exertion economic and social benefits. We should design a new manpower collocation standard for the secondary level hospitals.8. We find that doctor collocation and accomplished workload show their respective characters, and that the out-patient doctor collocation of most operational departments is similar by clustering analyzing.Conclusions and suggestions:1. Confirm the actual collocation number of out-patient department doctors according to the number of out-patients and manage the collocation dynamicly.2. Confirm the actual collocation number of in-patient department doctors according to the basic workload. Propose the workload standard of in-patient doctors.3. Establish the person development tactics suit to the secondary level hospitals. Deal with the indraught, cultivation and reservation of person with ability, the relation between the private and the team, the circumstance and civilization of the hospitals accurately.4. Innovate and explore the manage mode including the appointment system of clinical position and promotion system, reinforce the exploiture and train of health manpower resource and constitute the prompting distribution mechanism and scientific rational check system.5. Impel the collocation doctor numbers adapt to the demand and development of health service by establishing and actualizing the region health layout.