| Background: The shortage and imbalance of health human resources in rural and remote areas has become the global health problem that need to be solved urgently,which China is also facing.The ratio of urban and rural population in China is shrinking,but the density of urban health workers is much higher than that of rural health workers.And because of the level of regional economic development,environmental differences and other reasons,the problem of the lack of human resources in rural areas of Western China is particularly serious.Therefore,according to the actual needs of health workers in rural health care institutions in western China,it's very important to formulate and improve the rural health human resource policies in western China.Objectives: Based on the analysis of rural health human resource policies in western China,the health human resource policy is divided into four aspects: education,management,finance,personal and professional support.Through the investigation of the satisfaction degree of the health workers in the medical institutions at different levels in different provinces,analyzes the health workers' satisfaction with the health human resource policy,and discusses the reasons that may affect the satisfaction of health human resource policies,and provides the reference for the revision and adjustment of rural health human resource policies.Methods: From the 11 provinces in western China in accordance with the level of economic development of 33 counties of the people's hospital,maternal and child health hospital,CDC and Chinese medicine hospital;According to the size of the population,to select 3 township health centers in each county as the sample.Questionnaire survey: using five point Likert scoring method to design the health human resource policy satisfactionquestionnaire which was carried out among the health workers of the county medical institutions.Descriptive statistical method: descriptive statistics on the cognition and satisfaction of health workers in rural areas of the sample local health policies etc.;Horizontal comparison method and single factor analysis.Results:1.Investigation of health workers in rural areas in western China overall cognition and satisfaction of the health human resource policies,only 48.50% of health workers expressed awareness of health human resource policies in national and provincial,of which 24.52%were satisfied,53.41% had a general attitude and 22.07% were dissatisfied.2.By health workers on the health human resource policies satisfaction difference analysis,in the sample county people's hospital of health workers of different age,education background,the doctor internal category satisfaction have statistically significant difference(P<0.05);In traditional Chinese hospital and county CDC of health workers of different gender satisfaction have statistically significant difference(P<0.05);In county maternal and child health care group satisfaction difference doesn't have statistical significance difference(P>0.05);In township health centers' workers satisfaction difference between age,education background,doctors and nurses have statistically significant difference(P<0.05).3.Provincial health personnel's overall satisfaction is higher(78.57%),but there is still a part of the province of health personnel satisfaction is relatively low(70.00%).Provinces between medical institutions and health workers at all levels of satisfaction difference were statistically significant(P<0.05),there are difference between the average satisfaction of medical institution in the provinces,the whole of the guangxi zhuang autonomous region health manpower policies satisfaction is low.4.In terms of education policies,52.40% health workers must be the positive role of training,42.98% health workers said that training opportunities are insufficient,41.00% of the county CDC staffs to participate in the training of motivation is to solve practical problems,while others are in order to improve the level of health care,and the main problem is the lack of training and short training time.In terms of management policies,the turnover intention of the medical institutions is high,and the main reasons for the resignation of nearly 37.50%health workers are poor wages,the second is the personal value realization and competitive opportunities,etc.In terms of fiscal policies,high income have fewer health workers,43.63%of health personnel salary between 2000-2999 yuan,54.14% of health staffs were satisfied with the unit internal relative income,42.85% of health staffs expressed satisfaction when compared to other medical institutions;In the evaluation of the rationality of the incentive mechanism,66.87% of the health workers think it's reasonable,but there are still 31.12% of people think that it's not very effective.In terms of personal and professional support,69.68%health workers were satisfied with their living conditions,77.86% health workers are satisfied with occupation of work environment,opportunities to enhance medical institutions at the county level on the overall satisfaction is better than the township hospital.Suggestions:1.Accurate planning policies to benefit the scope of the efficient optimization of human policies content.2.All provinces in China complement each other and learn from each other's successful experiences.3.Improving the rural health manpower training system,strengthening grass-roots human continuing education.4.Establishing regional health manpower planning,building a reasonable mechanism of health manpower.5.Increasing fiscal policy and encouraging support for rural construction.6.Creating good personal conditions,improving the rural infrastructure. |
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