The Survey On Changes Of The Town And Village Health Professionals Between 2002 And 2010 In China

Objective: The new medical reform started in 2010. By carrying out the rural health professionals investigation again on this year, we can contrast the changes of the basic conditions of rural health technical staff between 2002 and 2010, and objective understand of rural health team building achievements and problems in these years, so as to provide a reference to continually improve and perfect the measures of the rural health team building and improve the capacity of health services in rural areas. Finally the amazing rural health team will help to provide a good human resource base on promoting the medical reform.Methods: The investigation carried out on 5 provinces which distributed in different parts of China and could represent the condition of vicinity very well. The study time was January to March 2010. The form was questionnaires. We used the multi-stage stratified cluster random sampling method to select the survey sites and units. Finally we chose 15 117 township hospitals and 1170 village clinics in the 3 levels survey sites which include 5 provinces, 15 cities and 36 counties. The overall accessible health staff in these township hospitals and village clinics were the respondents. At the last, 7788 questionnaires were handed out, and 7420 effective questionnaires were taken out. The effective rate is 95.3%. The data was inputted by Epidata3.1 and analyzed by the statistical analysis software SPSS17.0. The reference data was the same provinces the first rural health professionals survey data in 2002. The count data were analyzed byχ~2 test to compare the composition, and the ranked data were analyzed by two-sample Wilcox on rank sum test to compare distribution.Results: 1) From 2002 to 2010, the total number of the village doctors in the 5 provinces was reduced, while the staff in township hospitals was increasing. Similarly, the village doctor number per thousand rural population was also reduced, at the same time, the town doctor number per thousand rural population was also increasing. In particular, the village doctors in developed region also existed the brain drain, while the town and village doctors all reduced in underdeveloped areas which the village reduction was more serious. The proportions of town and village doctors in venerable age were all increased in that 8 years. The proportions of town and village doctors age less than 25 years respectively decreased from 31.7% and 6.9%, all accounted for about 5%. According to the working years distribution, the town and village new doctors were all poverty, while the village staff was more shortage. The town doctors which got the college diploma increased fast which the proportion grow from 8.9% to 42.4%, and the proportion without the education qualifications reduce from 32.4% to 15.9%. The proportion of village doctors who got the secondary education grow most fast which is from 48.9% to 56.4%. The proportions of town doctors who got the professional qualifications and attending physician professional title were all increased, the former is from 48.9% to 56.4%, and the latter is from 16.7% to 25.3%. But it shows the obviously profit-making tendency that the proportions of staff on clinical professional posts grow from 42.4% to 75.6%.Conclusions: 1) From 2002 to 2010, the health team in township hospital expanded steadily, and the total numbers of staffs and the personnel quality were all promoted. But the condition on the village clinics was opposite to the rural hospitals, which the total number of doctors reduced. 2) From the survey results, though the educational level, the training frequency, the professional qualification and the professional title level were all promoted, the age of rural health staff entirely tend to aging, the top level technicians and the general medical professionals were shortage, the leadership attention advocacy of the health bureau and financial input still need to strengthen. 3) The condition on the 5 province we investigated were representative in the whole country. Taking one with another, the health team building of township hospital and village clinic had accessed to a certain extent development, but there were still many accompanied problem. So the health administrative department in China should take more effective measures to further strengthen the rural health team building in future.