Study On Health Personnel Allocation In Zunhua City

Health personnel is a key indicator to reflect the level of health service of a country or territory, which is the most dynamic and active factor in health service system. The health personnel allocation study is important to strengthen the health service system. In order to improve the overall health of farmers and their quality of life, and take the lead in the province even in the country to achieve rural health reform and development goals, the health bureau of ZunHua city made a special study on the health resource allocation.1 ObjectivesThis study aimed at understanding the status quo of ZunHua health personnel allocation, analyzing the problems existing in personnel allocation, and using scientific methods to predict the amount of health personnel. It finally put forward the standards of health personnel allocation in ZunHua city and other related suggestions, expecting to make a reference for ZunHua City to optimize the allocation of health personnel, as well as provide reference for other areas in the country.2 Methods(1)Literature review Systematically look up a number of related literatures, with induction methods to find the common experience, so as to service for the design of this study follow-up analysis.(2)Case studyThe study mainly focused on the case of ZunHua city, tried to serve the ZunHua city health personnel allocation, while it also provided reference for the health personnel allocation in the whole rural area of China.(3)Statistics methodsIncluding descriptive statistics, comparative analysis, the methods to predict health personnel amount such as health services target, health demand, health need, the ratio of population, as well as health resources density index.3 Results and Analyses(1) The amount of ZunHua health personnel is limited The number of health professionals in medical institutions per 1000 population is 5.12 in ZunHua city in 2006, which is only higher than the average level of Hebei urban areas (5.29) but also lower than the national average 4.99 level. Comparing with the relatively developed areas such as Tianjin city, ZunHua CDC health personnel is limited. The allocation level of ZunHua CDC is 1.4 health persons per 10000 population, while Tianjin is 2.7-3.4 / 10000, ZunHua is significantly lower than those developed areas.(2)the number of health personnel is excessive in Maternal and child health care agencyThe allocation level of ZunHua MCH agency is 1.6 health persons per 10000 population, which is not only higher than the national average, but also higher than that of Tianjin MCH facilities(3)The difference of three-level health care network service efficiency is significanceThe study found that in accordance with the county, township and village three network of health care services, the service efficiency at all levels has significant differences. The daily visits of per doctor in county, township and village facilities are respectively 3.1, 3.0 and 6.8. Village clinics'outpatient efficiency is the highest among them, which is two times over the county health facilities and township health centers. However, as a hub for the entire service network, the efficiency of township health center outpatient services not only lower than the county hospitals but also village clinics, which is respectively lower about 96.77% and 44.12%. In addition, the daily burden of hospital beds per capita in county level hospital is 1.3, while that of township health centers was only 1.1. The inpatient efficiency of county level health facilities is nearly two times of township health centers.(4)There is inequity between urban and rural health personnel allocationZunHua study showed that urban and rural health personnel allocation is in a serious inequity. Its urban health staff per 1000 population is 10.4 while rural health professional is only 4.2. Urban health staff per 1000 population is more than twice than that in rural areas.(5)The composition of health personnel in different level is unreasonableThe personnel of county health facilities, township health centers and village clinics respectively accounted for 34.43%, 28.27% and 37.30%. The percentage of county health facilities is significantly higher than that of township and village, which will have impact on the efficiency and equity of health services. At the same time, as the medical services hub of the network, township health centers only have 28.27% of staff, this kind of "V"-shaped structure is apparently inconsistent with the national policy to develop and reconstruct the three-level health service networks.(6)The percentage of title junior is highZunHua city in 2006 for health personnel in medical institutions, the senior titles together is only 11.28%; the ratio was significantly lower than the country's average level of 44.5%, and less than its 1/4. Especially the percentage of senior titles in ZunHua city is only 3.66%, while it's 13.2% for the whole country, ZunHua city was 1/3 of the national average level. However, junior titles in ZunHua city is 88.72%, while the national average is 55.5% and 1.6 times of ZunHua city. Similarly, the public health service agencies exists similar problems.(7)The health personnel are too youngerAmong health professionals, the percentage of aged above 45 is just 13.93%, which is about 1/7 of total health professionals. And the proportion of persons under the age of 45 has reached 87.07%, especially with 64.19% under the age of 34. The health personnel are too younger.(8)The percentage of highly educated health professionals is lowOf all health professionals in medical institutions, those with college education and above accounted for 18.12%, a lower proportion of public health institutions, only 9%.(9)The percentage of public health professionals is low in CDCIn 2006, the health professionals of ZunHua CDC are only 51.49% of total staff. Professional public health practitioners is just 34.62% of health professionals, which means that public major health professionals is less than 30% of total personnel.(10)The percentage of for-profit service health personnel is highIn 2006, ZunHua CDC's operations focused on food hygiene, testing and other services which can bring more benefits to them, the person of these three kinds of health services accounted for 55.77% of health professionals. By contrast, the persons engaged in health education services, which are high yield and low-input services, is only 2%.(11)The definition of public health personnel and medical services personnel is unclear in MCH facilityIn 2006, MCH hospital in ZunHua has 88 professionals and, which includes both public health and medical services personnel. But the investigation found that the agency does not clearly define who are public health personnel and who are medical service personnel. Therefore, it's unable to clear the proportion of the public health service personnel.4 Suggestions(1)Suggestions for health personnel allocation in medical facilities Medical institutions gradually increase the number of health personnel. The total health personnel of ZunHua City in 2008 is 6491 persons, including 2587 doctors, 2587 registered nurses, other health technicians 1317 persons. Then, the level will be increased year by year with the socio-economic development. By 2012 the total number is 7294, including 2883 doctors, 2883 registered nurses, other health professionals for 1528. When we determine the total amount of health personnel, we also made the following recommendations to improve the health services efficiency and equity:①Introducing into senior staff to promote the percentage of senior title persons;②Reasonably planning the three-level health care network to strengthen the township health personnel construction;③Strengthening medical training to enhance the professional level of health personnel;④Actively creating conditions to introducing undergraduates or above;⑤Reasonably allocating health personnel between urban and rural areas to improve the equity of health services.(2)Suggestions for health personnel allocation in public health facilitiesThis paper recommends the total number of public health personnel is 765-911 during 2008-2012 in ZunHua city. As for CDC, it is recommended 189-238 persons, while Maternal and child health agency is of 140 persons (excluding medical services workers). Health inspection and supervision institution is recommended for 43-70 persons. Community and township prevention persons are 140. The full-time village prevention persons are 210-280.In order to optimize the allocation of health personnel of public health agencies, reference the problems discovered in the investigation, this paper made the following related proposals:①Gradually promoting the percentage of health professionals;②Implementing accreditation system strictly to enhance the percentage of public health professionals;③Regulate operation scope to lower the percentage of health personnel engaging in for-profit services;④Clearly define the public health personnel and medical service personnel.