Study On Allocation Fairness Of Medical Health Supervisors In Zhejiang Province

Objective:Through the understanding of the overall status of Zhejiang Province medical health supervisors,comparing the composition and differences on medical health supervisors among the provincial,city and county?district?health supervision agencies at all levels in terms of quantity,gender,age,working seniority,education,professionalism,professional titles,etc.And evaluating the fairness of the distribution of health care supervisors in Zhejiang Province.On this basis,analyzing the current problems and insufficiencies of medical health supervisors in Zhejiang Province,and discussing the challenges faced by medical health supervisors in Zhejiang under the new medical reform,making up some relevant recommendations,and finally providing a certain basis for regional health human resources planning.Methods:All the health supervisors engaged in medical and health supervision work in the three-level health supervision institutions in the provinces,counties,and counties within the jurisdiction of Zhejiang Province were included in the study.Using Composition Ratio and Chi-square Test,analyse the Basic Situation of Zhejiang medical health supervisors,and using the three analysis methods Gini coefficient,Theil index and concentration degree,analyze the overall fairness of the health care supervisors in Zhejiang Province according to the population,geographic area,density of population,GDP,GDP per capita and the object of supervision,as well as the fairness of each city and the fairness of each region.Sex,and analyze the sources of differences in fairness.Results:?1?Zhejiang Province had a total of 911 medical health supervisors,9 provincial health supervision bureaus,73 municipal health supervision agencies,and 829 county?district?level health supervision agencies;the number did not meet standard requirements;males are 481 female are 430,with a sex ratio of 1.12:1;the average age was 41.13 years,and the largest number of people under the age of 35 was 332?36.4%?;the average number of years of supervision was 11.88 years,The number of supervisors with 10-15 years of supervision is the maximum of 261?28.6%?;the majors studied were medicines,accounting for about two-thirds?66.1%?,but mainly preventive medicine?53.3%?,only 12.8%of clinical professions;academic qualifications are generally good,mainly undergraduate,with a total of 691 people?75.9%?,the municipal level,except for Jinhua,meets the standard requirements,and all district levels are up to the standard;different levels of health supervision agencies,medical health supervisors have different educational background,the difference in composition was statistically significant(c^?17?=27.357,P<0.001);the number of non-employed persons accounted for nearly half,which was 450?49.4%?,and senior staff members in various cities did not meet the standard requirements,different levels of health supervision agencies,medical health were different in their titles,and the difference is statistically significant(c^?17?=21.908,P=0.001).?2?The Gini coefficient of the health medical supervisors in Zhejiang Province according to population,geographic area,density of population,GDP,GDP per capita and the distribution of regulatory objects was:0.2042?0.4032?0.4056?0.3823?0.4012?and 0.2068,respectively;the Theil indices for Class I,Class II,and Class III regions were-0.0019 0.0116,0.0213,respectively,the overall Theil Index was 0.0255,the inter-regional and within the area Theil Index were 0.0182 and 0.0073,respectively,the difference between the regions was higher than the difference within the region,the contribution rate of the inter-regional difference was 71.3%;The aggregation degree of medical health supervisors among the first-category regions,the second-category regions,and the third-category regions were 1.28,1.06,and 0.45,respectively,and the aggregation degree of medical health supervisor in 11 cities of the whole province were between 0.23-1.95;the number of medical health supervisors basically meets the medical and health supervision and protection needs of the clustered population in the region,and the concentration of medical health supervisors gathered in the second and third categories of regions is relatively low compared to the population,and the subtraction between the aggregation degree of medical health supervisors and the aggregation degree of population concentration in 11 cities across the whole province is between-0.66-0.46.Conclusions:At present,the number of medical health inspectors in Zhejiang Province was relatively small and had not reached the national standard;the gender ratio was relatively balanced and the age structure is unreasonable;the medical health supervisor has a short working seniority;the professional composition of medical health supervisors remains to be improved,lack of major of legal and clinical medicine.The level of academic qualifications of medical and health supervisors was generally good,there were still some low-educated personnel in general meeting the national standards;the composition of medical and health inspectors constitutes unreasonable titles,there was a shortage of senior professional titles,there are a large number of junior titles and no titles people who fail to meet the national standards;health medical supervisors have better distribution of demographic and regulatory objects;fairness by geographical area,density of population and GDP per capita distribution was poor;disparities between health and medical supervisors are larger than regional differences.The unfairness was mainly due to the differences among the three types of regions;the health care supervisors in different cities had different fairness and poor geographical accessibility.Suggestion:Increase the number of medical health supervisors,especially in areas with insufficient personnel,people who major in law,clinical should be recruited;strengthen the training of clinical professional in post;innovate supervision methods and promote smart supervision;the geographic area,population density,and per capita GDP distribution should be considered should be taken into account when configuring the number of medical and health supervisors.