Investigation, Analysis And Countermeasures Of The Human Resource Situations Of The Community Healthcare Institutions In Baoshao District, Shanghai

With the continuous improvement of the community healthcare service system in Shanghai, the "six-in-one" healthcare burdens of the community healthcare institutions have increased. Consequently, to enrich the resource allocation on urban community healthcare institutions, especially the human resources, to meet the growing demand of health services among urban residents, has become an important research topic. The Baoshan District, as a north suburb of Shanghai, has a relatively insufficient health human resources. In recent years, inhabitant immigration has been on the rise, and the gap between the inhabitants’ health demands and the health human resources is enlarging. To solve such a problem well is not only the eager expectation of the inhabitants, but also what the government should focus on.This study employs qualitative and quantitive methods -- group interviews among 34 administrators and HR officers, open questionnaires among 180 staffs, and HR statistical surveys, to explore the human resource situations, problems and influential factors of clinicians, nurses, public health practitioners, other health professionals and non-health professionals of 17 community healthcare institutions in Baoshan District, Shanghai, and to propose an improvement suggestion.The research demonstrates that the human resources of the community healthcare institutions in Baoshan District, Shanghai have problems as following:1.Total staffs are insufficient and out-sourcing staffs are excessively massive. According to the population and the rational standard, the general practitioners, nurses and public health practitioners should sum up to no fewer than 2552, whereas the current total staff number is only 2179. The out-sourcing staffs account for 24.51%, among which the health professionals account for 74.72%.2.The personnel structure is not reasonable. Non-health professionals are disproportionally massive, accounting for 17.49% of the total staffs, much higher than "5%" ruled by the national authorities.3.Health professionals are insufficient with respect to the citizens. On average,10,000 citizens have 2.97 clinicians(1.54 general practitioners), 3.76 nurses and 1.25 public health practitioners, whereas the standard is: "10,000 citizens have 4-5 general practitioners; doctor-to-nurse ratio is 1:2-1:4; and 10,000 citizens have 1.5-2.5 public health practitioners".4.The education level of health professionals is low. Of the clinicians, 63.88% have the bachelor degrees,2.85% have the master degrees, and 11.57% have the technical secondary school degrees. The majority of nurses have the technical secondary school degrees, accounting for 44.66%. Of the public health practitioners,47.03% have the bachelor degrees,0.42% have the master degrees, and 28.13% have the technical secondary school degrees.5.Professional level of health professionals is unsatisfactory. The high-intermediate-low professional level ratio for clinicians is 1:16:12.26; for nurses is 0:1:4.45; for public health practitioners is 1:36:169, and for other health professionals is 1:47:206, whereas the agreeable ratio is 1:3:1, recommended by the WHO.6.Full-time preventive-care practitioners are in great shortage; part-time practitioners are disproportionally massive, accounting for 41.98%. Preventive-care practitioners have relatively low education level, of whom 32.31% have the associate bachelor degrees and 28.79% have the technical secondary school degrees.7.Human resource distribution is unequal among different areas. The staff number disparity between the area which has the most clinicians per 10,000 capita and that has the least is 4.35 times; for nurses is 3.37 times; for public health practitioners is 5.24 times.The reasons which incur the problems above are:1)The staff quotas of the community healthcare institutions increase slower than the population enlargement; 2)recruitment is sometimes wrongful and unjustifiable; 3)community health professionals have low salary and poor career development; 4)the recognition of general practitioners and public health practitioners among citizens is inferior, which injures their career satisfaction and experience; 5)some parts of the district have little attraction to qualified professionals due to the poor economic situation.To solve problems listed above, we propose several countermeasures and recommendations:1)to develop the human resource planning and management system for community healthcare, to speed up the adjustment of the staff quotas, to raise the salary for health professionals and to better their career development; 2)to regulate the recruitment and to improve the continuing education for the incumbent staffs; 3)to improve the training system of the general medical practice and to alter the medical education mode of the universities; 4)to apply contractual training of students, to give preferential promotion of professional titles, and to exploit the advantage of medical associations, in order to encourage medical professionals to join the community healthcare services; 5)to enhance the post management, performance appraisal and salary system.We hope that this dissertation would provide a valuable reference to the authorities, to help them develop useful policies of human resource management for the community healthcare institutions.