| Objective:General practitioners,as the backbone of grassroots health services,play an important role in strengthening the capacity of grassroots health services.However,the education of general practice started late,and the incentive mechanism of the general practice is not perfect,which leads to the shortage of talents.In order to strengthen the training number of general practitioners and improve the talent incentive mechanism,taking Shanxi Province as an example,based on the analysis and prediction of the current number of general practitioners,this paper makes an in-depth investigation and analysis of their practice,cognition and post competence,to explore the problems and influencing factors in the current development of the general practitioner team in Shanxi Province,so as to provide corresponding solutions and provide theoretical basis for accelerating the development of the general practitioner team in Shanxi Province.Methods:The number of general practitioners in all provinces in China was obtained from China Health Statistical Yearbook,and the number of general practitioners in Shanxi Province was compared.The optimal weighted combination model was used to predict the number of future development of general practitioners,and the target of the expected number of personnel training and staffing was compared.A self-made questionnaire was made to investigate in-service general practitioners in Shanxi Province,including general demographic characteristics,practice status,cognitive status and post competency assessment.The obtained results were sorted out and analyzed by Excel2019,SPSS25.0 and R4.2.0.Results:(1)The number and growth rate of general practitioners per 10,000 population in Shanxi Province is lower than the national average level: by 2020,the number of general practitioners in Shanxi Province accounts for 1.72% of the national total,ranking 24th;Shanxi has 2.01 general practitioners per 10,000 population,ranking fourth from the bottom in China.From 2012 to 2020,the average annual growth rate of the number of general practitioners in Shanxi Province was 13.51 percent,ranking fourth from the bottom in China.Shanxi Province is expected to have 3.35 general practitioners per 10,000 people by 2025,and it is difficult to achieve the target of 3.93 general practitioners per 10,000 people.(2)The structure of in-service general practitioners in Shanxi Province is unreasonable,and the problem of "one big and six low" is prominent.By investigating 170 serving general practitioners in Shanxi Province found that the average age of 43.10±7.253 years,under the age of 40 general practitioners number accounts for only 28.8% of the total amount of investigation,young doctor shortage,on-the-job general practitioners age is " oversize";42.4%of doctors have been in practice for less than 10 years and lack of service experience;54.1%of the doctors had junior college as their highest education,and their overall education is "low".73.5% of general practitioners provide health services at the grassroots level,but only23.5% work in community health service stations or village clinics.A large number of general practitioners fail to go to communities or rural areas where residents need them most,and the proportion of general practitioners between communities and rural areas is "low".68.2% were transferred to general practitioners;69.4% of doctors were not registered as general practitioners after obtaining the registration qualification of general practitioners,and the registration rate of general practitioners after obtaining the registration qualification is "low";45.9% of general practitioners did not establish or join a team of general practitioners and chose to practice medicine alone;84.7% of the general practitioners plan to continue their studies,it indicates that the satisfaction of general practitioners on their service ability is "low" at present.,and there is an urgent need to strengthen their own health service capacity;The overall evaluation of job satisfaction is "average",especially the evaluation of current income satisfaction is "relatively unsatisfied",it indicates that the satisfaction of general practitioners on their income level is "low";"Relatively agree" with the cognition of the general practitioner profession;Index of post competency assessment level,the highest score is "humanistic practice ability",for "7.41±1.659",is the lowest mark "public health service ability",for "6.97±1.671",the public health service level of competence is "low".(3)The survey of 170 active general practitioners’ willingness to continue practicing found that 38.2% of them did not want to continue working in general practice.The regression analysis on the factors influencing the practice intention of general practitioners found that the general practitioners who had registered as general practitioners,had a team of general practitioners,had the intention to continue to study,and had a high post competency score were more willing to continue to work in general medicine,and the influence was significant(P<0.05).Conclusions:Taking Shanxi Province as an example,this study investigated and analyzed the changing trend and influencing factors of the number of general practitioners,and reached the following conclusions:(1)The existing general practitioner registration base is small,the growth rate is slow,the registration rate is low,and the willingness to continue to practice is not high,which leads to the realization of the goal of the number of general practitioners in Shanxi Province may be challenging;The internal quantity allocation structure of grass-roots general practitioners is not good,and the number of general practitioners providing services in community health service stations and rural clinics is insufficient.Low evaluation of current job satisfaction,especially dissatisfaction with income level.(2)The post competency and service capacity of in-service general practitioners need to be further improved,especially the low competency level of public health services,which indicates that general practitioners lack the competency for group health services.(3)The main factors that hinder the continuation of practice of general practitioners are the lack of registration intention of doctors,the lack of establishment of a general practitioner team,the lack of their own post competency and the lack of opportunities for further study.Once registered as a general practitioner,they can improve their post competency and work efficiency through further training and establishment of a general practitioner team.It will be a positive factor to stimulate the sustainable development of the general profession.Suggestions:It is suggested that Shanxi Province should focus on the two goals of "retaining and using" to improve the incentive policy of general practitioners.On the one hand,it is suggested to improve the income level of general practitioners,enhance the construction of general practice team,enhance the job attraction,improve the practice registration rate of general practice talents after training,and let the qualified general practitioners stay in the grassroots general practice post.On the other hand,it is suggested to strengthen the service capacity building of general practitioners.For example,according to the health-centered service characteristics of general practitioners,the construction of general practitioners and the continuing education of public health service ability enhanced by group health service ability should be strengthened,so as to enhance the competence of general practitioners and the sense of practicing honor.In the future,it is suggested to innovate the evaluation system of the service effect of general practitioners,so as to further stimulate the enthusiasm of general practitioners in providing services. |
