The Investigation Of Current Situation And Equity Of Human Resource Of Community Health Service In Guangdong Province

Object:The aim of the study is to understand the current development situation of humanresources in Community Health Service Centers (CHSC) in Guangdong province in2008, to analyze the assignment and the distributed of human resources in term ofpopulation and geography, discuss the effective measure to improve the assignment ofhuman resources and provide scientific basis for the government to work out adevelopment plan in improving the human resources assignment.Methods:The data of this study was selected from result of the general investigation ofcommunity health service centers of Guangdong Province in2008; the generalinvestigation was completed by the Health Department of Guangdong Province in2009. Describing the basic situation of CHSC, and human resource allocation, includedstaff numbers, ages structure, educational background, title structure and the rate ofreceived general practice training, and combine some other data like GuangdongStatistical Yearbook2008to analyze the equity of human resources allocation by Ginicoefficient and Thei lindex. Data processing and analysis completed by EXCLE2003and SPSS16.0. Results:1. A total of990community health service centers’ human resources data in21cities of Guangdong Province was gotten, including the Pearl River Delta, Eastern,Western, Northern. Four regions of Guangdong Province owned845,57,53,35community health service centers, respectively. CHSC in Guangdong Provincecoverage serviced population of8.23million. The Pearl River Delta, Eastern, Western,Northern coverage serviced population of4.31,3.83,7.67,5.64million, respectively.2. There was46139staff in990Community Health Centers,38126healthtechnicians (82.63%),2536managers (5.50%),2772support staff (6.01%),2705other technical staff (5.86%).3. In38126health technicians, there was14553clinicians, accounted for38.17%,1896public health doctors, accounted for4.97%,14536nurses, accountedfor38.13%,3893pharmacists, accounted for10.21%,3248medical technicians,accounted for8.52%.4. There was average46.61health workers,36.51health technicians,2.56managers,14.70clinicians,1.92public health doctors,14.48nurses per CHSC inGuangdong Province.5. there was46,139health workers in990centers, including20,688formalworker (44.84%),17,326contract worker (37.55%),27,533temporary worker(16.33%),592rehired worker (1.28%). Pearl River Delta, the proportion of contractworkers is highest as43.25%; the proportion of formal workers in Eastern was highest,accounted for79.08%.6. The age of the health technicians was concentrated in25to35, whichaccounted for47.10%. Manager’s ages concentrated in35to44, accounted for 34.00%.7. Health technicians mainly owned secondary or tertiary diploma, accounted for36.88%; the proportion of managers undergraduate accounted for38.17%; theproportion of clinicians who received undergraduate or higher education was39.56%.Public health doctors mainly graduated from secondary school, which accounted for33.86%. In nurses, the proportion of graduated from secondary school was50.96%.Health technicians mainly owned primary title, accounted for67.23%. Managersowned junior title accounted for30.06%. Clinicians got junior title accounted for53.95%. The proportion of public health doctors owned junior title as high as63.29%.Nurses got junior title accounted for79.55%.8. The proportion of the medical treatment and nursing was1:0.88in CHSC ofGuangdong Province, the proportion of Pearl River Delta, Eastern, Western, Northernwas1:0.95,1:0.40,1:0.70,1:0.69, respectively.9. The ratio of clinicians received general practice training was21.52%; nurse’sratio was19.77%in CHSC of Guangdong Province. The ratio of Pearl River Delta,Eastern, Western, Northern CHSC clinicians received general practice training was24.97%,7.18%,9.52%,3.2%, the ratio of nurse in the four region was21.58%,6.71%,10.87%,2.64%.10. In2008, the Gini coefficient under population of health workers,healthtechnicians，senior health technicians, managers, clinicians, public health doctorsand nurse in CHSC of Guangdong Province was0.38,0.38,0.55,0.30,0.21,0.410.44.The Gini coefficient under geography was0.78,0.78,0.87,0.74,0.76,0.75,0.82.Community health human resource allocation under population was better than thegeography allocation. 11.Within-regions Population-Theil index of health workers, health technicians,managers, clinicians, public health doctors, nurses is higher than inter-regionspopulation-Theil index in CHS of Guangdong Province in2008,indicating thatwithin-regions health resource allocation was better than the allocation ofinter-regions.Inter-regions Population-Theil index of senior health technicians washigher than winthin-regions Population-Theil index,reflecting poor inter-regionsallocation of senior technicians base on population.12. Inter-region Geographphy-Theil index of health workers, health technicians,senior health technicians,managers, clinicians, public health doctors, nurses washigher than within-regions Geographphy-Theil index. It was reflecting poorerinter-region allocation of CHSC human resource than within-region allocation base ongeographphy.Conclusion:1. The system of employment far from satisfied.2. Community Health Center health staff positions setting is not reasonable,education background and professional title structure was not reasonable. CHSClacked public health physicians and nursess.3. The allocation of health human resources of CHSC in Guangdong Provincewas unbalance.4. The rate of health care workers’ general practice training was low, and therewas a large gap between inter-regions in general practice training. More generalpractice staff needed for CHSC.Suggestions:1. The government should take more responsibility and more investment should be supply for developing health human resource.2. Drawing up a plan for community health resource development, makingoverall and balance distribution for community health human resource between cities.3. Deepen the reform of Community Health, to improve the employmentsystem.4. To regulate the staffs’ structure, professional health technicians should beallocated rational for CHSC.5. Making an excellent community health services team, improving generalpractice personnel training system of community health service.