The Quantity,Structural Changes And Allocation Equality Of Health Workers In The Center For Disease Control And Prevention In China

Object: This thesis aims to analyze and evaluate the quantity,structural changes and equity of allocation of health workers in Center for Disease Control and Prevention in China.Furthermore,to improve and strengthen the health workforce,so as to provide targeted policy recommendations.Methods: The changes in the quantity and structure of health workers in Center for Disease Control and Prevention was analyzed by using the magnitude of change,the value of structure variation and the attribution ratio of structure variation;the spatial auto-correlation was used to analyze the spatial allocation level of health workers;and the Gini coefficient,Lorenz curve,Theil index and agglomeration were used to analyze the equity and changes trend of health workers.Results: 1.In terms of health workers stratum changes in the Center for Disease Control and Prevention,both provincial and county-level institutions health workers showed negative structural changes in 2010—2020,with decreased in health workers attributable to the provincial(-27.1%)and county-level(-205.5%),respectively.In contrast,both the provincial and other tiers institutions of health workers showed negative structural changes in 2019—2020,with contributions of-0.6% and-2.9%,respectively.Except for the provincial institutions,the average of health workers in prefecture-level municipalities,counties and other tiers institutions showed an upward trend.2.In terms of changes in the types of health technicians,from 2010 to 2020,licensed(assistant)physicians and other personnel showed negative structural changes,while the remaining types of health technicians showed positive structural changes.The decrease in health technicians was mainly attributed to licensed(assistant)physicians,with a contribution rate of-324.5%,and the increase in health technicians was mainly attributed to registered nurses,with a contribution rate of 203.0%.In comparison,all categories of health technicians showed positive structural changes in 2019—2020,except for licensed(assistant)physicians,who showed negative structural changes.However,the increase in health technicians was mainly attributed to licensed(assistant)physicians,with a contribution rate of 33.2%.3.In terms of changes in the composition of health technicians,by age,the decrease in health technicians from 2010—2020 was mainly attributed to the 35～44 age group(-130.9%),and the increase in health technicians was attributed to the 55 and older age group(142.3%).In contrast,the increase in health technicians in 2019—2020 was mainly attributable to the 25～34 age group(27.1%).By education,the growth of health technicians in 2010—2020 and 2019—2020 were attributed to those with a bachelor’s degree,with a contribution of 364.9% and 124.3%,respectively.By title,the growth of health technicians in 2010—2020 was attributed to the senior title group(91.3%)and the decline in health technicians was mainly attributed to the intermediate title group(-124.4%).The growth of health technicians in 2019—2020 was mainly attributed to the junior title group(53.8%).4.11 provinces had met the standard for health workers at 1.75 persons per 10,000 resident population in 2010,while only 8 provinces had met the standard by 2020,and the provinces that had not met the standard were mainly concentrated in the eastern and central regions.Only the eastern region had a positive structural change in health workers in 2019—2020,while the central and western regions had a negative structural change,but the central and western regions had a positive contribution with a contribution rate of10.0% and 31.7%,respectively.5.The spatial correlation of health workers resources was strong.The global Moran’s I index was decreasing,and the concentration of the spatial distribution of health workers resources was decreasing.In terms of the local Moran’s I index,the health workers per 10,000 resident population was relatively stable in 2010,2019 and 2020,with only individual provinces experiencing changes.6.In terms of the overall equity of the health workers,we obtained the range of Gini coefficient for the health workers by population from 0.1562 to 0.1617 in 2010—2020,showing an optimal average.The range of Gini coefficient by geographical area distribution was between 0.5863 and 0.5920,which indicated alarming.The range of Gini coefficient by economic distribution was between 0.2915 and 0.3153,which was between average and normal status.Looking specifically at the sources of inequity,the total Theil index for the health workers by population in 2010—2020 range between 0.0389 and 0.0415,with inequity in health workers originating mainly within regions.The total Theil index by geographic area distribution for the same period range from 0.8018 to 0.8376,with inequities in health workers also originating mainly within regions.The total Theil index by economic distribution ranged from 0.1356 to0.1641,with inequities in health workers originating primarily between regions.7.From the agglomeration of health workers,in 2010—2020,the various types of health workers in the eastern and central regions of the Center for Disease Control and Prevention were relatively too much by geographic distribution,while the western regions were relatively insufficient.Based on the agglomeration ratio,we got the various types of health workers clustered in the eastern region were under-distributed by population in 2010—2020,while in the central and western regions were relatively more than the number of population.Conclusion: The health workers of Center for Disease Control and Prevention is still insufficient.The structure of health workers is still irrational.The spatial auto-correlation generally decreases over time,and the concentration of spatial distribution of human resources is shrinking.The equity of health workers allocation by population distribution is good,and there are differences in the equity of health workers allocation for each category.The inequity in the allocation of health workers by population and geographic area distribution mainly originate within regions,and the inequity in the allocation by economic distribution mainly originate between regions.The distribution of health workers by geographic area and by population in eastern,central and western regions are uneven.Recommendations: To improve the social status of Center for Disease Control and Prevention,improve the situation of "medical care but not prevention";strengthen the construction of talent team,expand the total quantity of health workers;optimize the internal structure of health workers,improve the situation of health workers echelon;plan the health workers according to local conditions,improve the quality of health services;explore the positive and effective talent incentive mechanism,improve health workers remuneration and treatment.