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Infection prevention and control(hereinafter referred to as " infection control" )practitioners are the backbone of infection control teams of individual departments. Their capacity-building is key to improving the management efficiency at both hospital and department levels, which can effectively ensure medical safety. Since 2017, a tertiary traditional Chinese medicine hospital had scored desirable results based on the analysis of the problems existing in their capacity-building. In its explorations, the hospital attempted to improve the professional competency and management ability by the following measures. These measures included improving and standardizing the organization and management, establishing an on-the-job training system, formulating an annual management manual of department′s infection control teams, implementing a cross inspection system and patrol system of the practitioners during an epidemic, establishing an assessment and evaluation system and incentive mechanism, establishing infection control elite teams, and building a mode dominated by infection control doctors. These experiences can provide reference for optimizing the capacity building of the infection control practitioners.
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In the case of public emergency, cross regional and institutional deployment of health technicians as a contingency measure is imperative in alleviating the shortage of medical resources and improving the medical capacity in the location of emergency. The authors rounded up common modes of such deployment, namely independent deployment of a complete organization, deployment by job division for individual responsibility, deployment of individuals joining in a cooperative action, and that of expert guidance. In practice, the emergency deployment of health technicians was faced with serial challenges, such as their mobility, interoperability, professionalism, economy and persistence. To improve the performance of emergency deployment, it is necessary to strengthen the routine emergency skill reserve and simulation drill, to formulate " wartime" joint diagnosis and treatment decision-making rules, to build high-level health emergency teams, to establish and improve a complete, flexible and orderly deployment mechanism of such human resources, and to improve the honor award and reward system for health emergency personnel.
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OBJECTIVE@#To analyze the long-term trends of the changes in the equity of China's health workforce allocation to provide a reference for the more balanced and orderly development of China's health system.@*METHODS@#The Gini coefficient was used to evaluate the degree of equity in the allocation of health workforce between regions, and the Gini coefficients for the allocation of doctors and nurses based on population and regional gross domestic product (GDP) distribution were calculated respectively.@*RESULTS@#In 2019, the number of licensed (assistant) physicians per 1 000 population in China was 2.77, and the number of registered nurses per 1 000 population was 3.18. The Gini coefficient for the distribution of licensed (assistant) physicians by population was 0.141 in 2002, decreasing to 0.081 by 2014 and then remained stable. The Gini coefficient for the distribution of registered nurses by population was 0.164 in 2002 and decreased to 0.066 in 2018. The Gini coefficient for the distribution of licensed (assistant) physicians by GDP was 0.236 in 2002, decreased to 0.169 in 2013, then increased to 0.183 and remained stable. The Gini coefficient for the distribution of registered nurses by GDP was 0.206 in 2002, decreased to 0.150 in 2013, and then increased each year to 0.180 in 2019. The equity of the allocation of registered nurses by population was worse than the equity of the allocation of licensed (assistant) physicians in 2002, and in 2016, for the first time, exceeded that of licensed (assistant) physicians.@*CONCLUSION@#Equity in the allocation of health workforce across China has improved, but the improvement in equity between regions has hit a bottleneck, with health workforce allocation in the western regions still relatively scarce. Although nursing workforce allocation equity caught up with licensed (assistant) physicians, the number of licensed (assistant) physicians is close to that of developed western countries, while there is a large gap in registered nurses. It is recommended that the relevant authorities make good long-term planning for health workforce, further increase the policy for the introduction of health workforce in the western region, and increase the supply of healthcare services in the western region with the help of digital transformation of healthcare and internet healthcare. At the same time, they should further increase investment in resources for higher nursing education and actively plan to cope with the ageing population.
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Humans , China , Health Equity , Health Services , Health Workforce , WorkforceABSTRACT
Objective:To analyze the staff salary status and the influencing factors in traditional Chinese medicine(TCM) hospitals implementing the salary system reform in Sichuan province in 2020, for reference in optimizing the salary system reform of such hospitals.Methods:Cluster sampling and institutional survey were used to collect the salary information of 26 TCM hospitals in 21 cities(prefectures)of Sichuan province implementing the salary system reform in 2020. Such information was then subject to descriptive analysis, while the influencing factors of salary were subject to one-way analysis of variance and generalized linear model multifactor analysis.Results:15 428 staff from 26 TCM hospitals were included as the research objects. In 2020, personnel expenditure accounted for 40.23% of the total expenditure, and 24.34% of which came from financial subsidy in 26 TCM hospitals. The average annual payable income per person was(149 312±74 288)yuan, 67.82% of which being performance pay. Analysis of variance showed that there were significant differences among the salary levels of staff in different economic regions, hospital grades, hospital levels, gender, educational background, position, seniority, performance pay ratio, employment in the government system and other natures, senior and other professional titles, doctors and other positions( P<0.05), and the differences were still statistically significant after adjustment by generalized linear model( P<0.05). Conclusions:The reform of the salary system of Sichuan TCM Hospitals has basically achieved equal pay for equal work, and the income of low-level personnel has been improved. However, the salary level was not very motivated and the salary structure was not guaranteed. It is necessary to strengthen financial precision subsidies, increase the proportion of personnel expenditure, so as to support the increase of the absolute value of salary in non-core economic areas, improve the salary structure, reasonably widen the salary gap among different educational backgrounds and positions, further optimize internal distribution, and ensure the sustainable development of Chinese medicine talents.
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Objective:To analyze the salary characteristics of medical institutions and the influencing factors of personnel expenditure as found in the salary system reform of public hospitals in Sichuan province, for reference in furthering such reform in public hospitals.Methods:The data of personnel expenditure, business operation and medical services came from 96 medical institutions in 21 cities(prefectures)of Sichuan province from 2017 to 2020 by means of institutional survey. The average salary level and salary structure of medical staff were used to describe the salary characteristics, and the total salary was presented by the level of personnel expenditure. The measurement data was represented by M(IQR), the counting data was described by frequency and constituent ratio, and the influencing factors of personnel expenditure were analyzed by generalized linear mixed model. Results:From 2017 to 2020, the personnel expenditure of medical institutions increased by 13.04% annually. In 2020, the per capita salary level of medical staff was 151 900 yuan, while the basic salary and performance salary accounted for 16.20% and 54.60% of personnel expenditure respectively. The analysis results of the generalized linear mixed model showed that the average cost of patients per visit( β=0.596), the level of drugs and sanitary materials consumed per 100 yuan medical income( β=0.286), the number of medical visits( β=0.328), and the years [(2018, 2019, 2020) β=0.025, 0.052, 0.066] were positively correlated to personnel expenditure, while the average length of stay( β=-0.693), the proportion of medical service income( β=-0.392), and the balance rate of income and expenditure( β=-0.062)were negatively correlated to personnel expenditure( P<0.05). The proportion of fiscal subsidy revenue, regional GDP and asset-liability ratio were not the influencing factors of personnel expenditure( P> 0.05). Conclusions:In the reform of the salary system of the province, its salary level of medical institutions has surpassed the current wage ceiling of these institutions. As the salary distribution was mainly made based on the workload, the " baton" role of the salary system reform has begun to pay off. However, the basic guarantee role of compensation has not yet been fully leveraged.Further reform is needed in upgrading refined management, and timely dynamic adjustment of personnel expenditure in combination with the hospital's financial performance and cost analysis, and reasonably optimizing the level of medical staff compensation.
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The professional title evaluation of health professionals needs to highlight the clinical performance and actual contribution, and make full use of the information system of medical and health institutions to collect relevant data as an important basis for such evaluation.Based on this, the project team innovatively developed a " clinical work data extraction system" , to extract and calculate the performance indexes of clinicians using data from homepages of medical records. Meanwhile, the team established a reference scale based on the data in the hospital quality monitoring system; developed a " health workers evaluation data platform" , visually presenting the comparison results between the clinical work performance evaluation data of a clinician, and the reference scale and the data of other applicants. In the 2021 annual evaluation of senior professional titles among some medical institutions directly under the National Health Commission and such provinces as Sichuan, Shandong and Chongqing, this method was used to extract homepage data of medical records of 7 833 applicants from 39 medical specialties in 1 416 medical institutions, and finally 6 093 people (77.79%) completed the calculation of clinical work evaluation index data. The initial application results showed that the evaluation of senior clinicians′ professional competence based on homepage data of the medical record was feasible in the senior professional title evaluation of various medical institutions at all levels equipped with the electronic medical record database system, and could effectively present the performance level and actual contribution of the applicant.
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Optimizing the salary system of general practitioners and establishing a compensation incentives mechanism fitting its needs, would contribute effectively to the development of the general practitioner system in China. Fully leveraging the salary incentive system, the United Kingdom(UK) effectively improved the working enthusiasm of general practitioners and its quality of primary medical services, and limited its medical expenses as well. The authors expounded the incentive mechanism of general practitioners′ salary in the UK from such dimensions as salary model and salary structure, and introduced the implementation effect. Based on Robbins′ comprehensive incentive theory, the authors introduced the internal logic of the UK′s general practitioners′ salary incentive mechanism. Based on the UK experiences, along with existing problems in China, the authors recommended on setting up value-based salary levels, optimizing the salary structure, and establishing a dynamic adjustment mechanism. These ideas are expected to help optimize the salary incentive mechanism for general practitioners in China.
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Under the situation of regular epidemic prevention and control of COVID-19, the hospitals need to establish an emergency personnel pool and update it regularly. The author introduced the experience of establishing and managing the emergency personnel pool in a hospital, including the use of information technology to achieve scientific grouping and dynamic management, strengthening the emergency response ability, epidemic prevention and control training and assessment of all staff, ensuring their mental health and logistics support, and improving the performance assessment, salary and welfare system of emergency personnel.From December 2021 to May 2022, the members of the emergency personnel pool completed a total of 62 emergency support tasks. The response time and team gathering time of all emergency tasks were reduced to less than 1 hour. A total of 4 421 medical personnel were sent. The nucleic acid test results of COVID-19 during the tasks were negative, the infection rate was zero, and no adverse events occurred.
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Health manpower is key to the functioning of the health system. There exists a general need to strengthen health human resources in countries at large as they achieve universal health coverage. Through the systematic collection and sorting out of the declarations, initiatives, guidelines in the world and topics at the World Health Assemblies on health manpower-related issues since 2000, this paper summarized and analyzed the key issues and trends on health manpower planning, education and training, international migration, and compensation management, in order to provide reference for China′s health manpower management and practice.
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The authors systematically reviewed the progress of health human resources development, personnel management system and conceptual changes from 2011 to 2020 in China, and analyzed the status quo in this regard. The past 10 years have witnessed rapid progress of health human resources, namely better personnel management system and constant innovation in human development concepts. As required by the strategy of empowering the country with talents in the new era, as well as the overall promotion for the Healthy China initiative and the high-quality development of the health industry, higher requirements have been put forward for the quantity and quality, structural distribution and management innovation of health human resources. Therefore it is necessary to further expand the coverage of talents work and innovate talents policy, thus keeping the upgrade of the capability and competence of health talents.
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In the context of the construction of " double sinking and double upgrading" in Zhejiang province, a provincial hospital explored a pilot talent working mechanism of " provincial hospital recruit staff and county hospital get experts" in the process of cooperating with county hospitals. In view of the problem that high-quality medical human resources were difficult to sink, with the flexibility of the reform of post filing and staffing, we put forward the idea of " provincial hospital recruit staff and county hospital get experts" , established key support disciplines, recruited staff by provincial hospitals, and arranged experts to precisely " sink as needed" to help disciplines of county hospitals. It helped to explore the establishment of a long-term mechanism to promote the flow of excellent medical talents to remote mountain areas, built a " specialized community" of provincial and county hospitals, and improved the medical service capacity, medical quality and discipline construction of county hospitals.
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Objective:To explore the influencing factors of turnover intention of pre-hospital emergency nurses in Beijing, and provide references for reducing the turnover rate of pre-hospital emergency nurses and stabilizing the pre-hospital emergency nursing team.Methods:Pre-hospital emergency nurses from 2 emergency centers in Beijing were selected as the survey objects, and a self-designed questionnaire was used to conduct an online survey in September 2019. The questionnaire covered such aspects as the main demographic characteristics, workload, doctor-patient relationship, professional identity, job burnout and turnover intention. Descriptive analysis was conducted for the data, while rank-sum test and Kappa consistency test were used for univariate analysis, and ordered logistic regression analysis was used for multivariate analysis.Results:A total of 340 valid questionnaires were received, among which 41.5% (141) of the nurses said that they occasionally considered quitting, 11.7% (40) said they often considered quitting, while the scoring of professional identity was (33.29±6.00), and that of job burnout was (63.70±14.90). Univariate analysis showed that age, work units, self-rated health status, professional identity, job burnout, seniority, workload, doctor-patient relationship, and pressure of title promotion were significant ( P<0.05). The results of multivariate analysis showed that job burnout, average number of car trips per shift, and self-rated health status were positively correlated with turnover intention, while professional identity was negatively correlated with turnover intention ( P<0.05). Conclusions:The turnover intention of pre-hospital emergency nurses in Beijing was found at a high level. The authorities are recommended to rationalize the scheduling system and increase the staffing of pre-hospital emergency nurses; establish the diversion policy, title promotion system and post risk special allowance for such nurses; and train medical aid workers to undertake the transfer and lifting of patients, so as to reduce the turnover intention of these nurses.
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Objective:To explore the driving mechanism contributing to doctors′ turnover intention in public hospitals based on the grounded theory.Methods:" Willingness or intention for doctors to quit public hospitals" was used as the theme word, and the literature was retrieved from CNKI published from January 1, 2017 to January 1, 2022. Based on the grounded theory, NVivo 11.0 software was used for a qualitative analysis of the literature. The three-level coding method of open coding, axial coding and selective coding was used to identify the main categories affecting the willingness of doctors to quit public hospitals. On this basis, the driving mechanism model was integrated. In-depth interviews with hospital managers were used to test the theoretical saturation.Results:When 31 papers were coded, four level-1 influencing factors of the formation of doctors′ turnover intention in public hospitals were summarized: career selection deviation, practice reality, perceived experience and external opportunity. Among them, perceived experience was the direct driving factor; career selection deviation was the initial driving factor, and the practice reality was the key driving factor, both of them affected the perceived experience; external opportunity was the possible driving factor.Conclusions:In order to prevent doctors from willing to leave, the following measures are expected: the hospital management should improve both its recruitment evaluation indexes and recruitment effectiveness; pay attention to doctors′ psychological capital management and cultivate positive perception; promote the reform of performance pay, emphasize fairness and value; pay attention to employee relationship management and build a supportive hospital culture.
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Este manuscrito objetiva relatar uma prática de Educação Permanente em Saúde para qualificação do processamento e esterilização de materiais de uma Central de Materiais Esterilizados em um cenário de Estratégia Saúde da Família, a partir da integração ensino-serviço. A experiência foi realizada em uma Unidade Básica de Saúde situada no Oeste de Santa Catarina, durante o segundo semestre de 2016, envolveu estudantes e docentes de uma universidade pública e 11 trabalhadores da Estratégia de Saúde da Família. Realizou-se reunião com a coordenação, roda de conversa com os profissionais e elaboração de instrumentos (checklist e procedimento operacional padrão). As atividades de Educação Permanente em Saúde favoreceram a transformação da práxis dos atores do serviço e da academia, possibilitando o diálogo corresponsável pela qualificação da assistência, segurança do paciente e gestão do trabalho.
This manuscript aims to report a Permanent Education in the Healthcare field to qualify the materials processing and sterilization in a Material Sterilization Center in a practice scenario of Family Health Strategy, based on the service-learning integration. This experience was conducted in a Health Center located in the West of Santa Catarina, during the second semester of 2016, involving students and professors of a public university and 11 workers of one Family Heath Strategy. A meeting was held with the coordinator, a round-table discussion and the elaboration of tools (checklist and standard operating procedure). The activities of Permanente Education in the Healthcare field have favored the praxis transformation of those working in the service and academia, enabling a responsible dialogue for qualification of care, patient safety, and work management.
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Primary Health Care , EducationABSTRACT
Introdução: A saúde coletiva constitui-se como um campo de saber voltado para a compreensão da saúde e a explicação de seus determinantes sociais, e o âmbito de práticas direcionadas prioritariamente para a sua promoção. Pela sua caracterização, a saúde coletiva é um campo que possui potencialidades para contribuir na reorientação das práticas de saúde das diferentes profissões da área da saúde, como a fonoaudiologia. No Brasil, o fonoaudiólogo iniciou sua prática voltada para a saúde escolar, entre as décadas de 1920 e 1940, com práticas embasadas na pedagogização da saúde e medicalização da educação. Entre 1950 e 1970, direcionou seu trabalho para os consultórios particulares e clínicas de reabilitação. Nos anos 90, com o recém criado Sistema Único de Saúde (SUS), foram identificadas lacunas na atuação do fonoaudiólogo, iniciando-se os estudos para repensar a sua formação no contexto da saúde pública. Objetivo: Analisar a formação em saúde coletiva nos cursos de fonoaudiologia de Instituições de Educação Superior (IES) públicas. Método: Para a produção dos dados foram realizadas entrevistas com informantes-chave discentes e docentes de sete IES públicas do Nordeste. As entrevistas foram gravadas, transcritas, categorizadas e analisadas através da Análise Temática de Conteúdo. Além disso, foi realizada uma análise documental de currículos lattes dos docentes fonoaudiólogos responsáveis pelos componentes curriculares de saúde coletiva nas IES públicas brasileiras identificados através da técnica "bola de neve". Esta análise permitiu identificar o perfil da formação, atuação e publicação dos docentes. Os dados produzidos foram organizados no software IBM SPSS versão 20, gerando estatísticas descritivas, e sendo realizada a análise de correspondência múltipla. Resultados: Identificou-se na análise das entrevistas dos estudantes que esses possuem experiências formativas na saúde coletiva que favorecem uma aprendizagem no SUS, mas que possuem fragilidades na interprofissionalidade e na integração de conteúdos. Já nas entrevistas com os docentes, observou-se que os cursos de fonoaudiologia possuem uma heterogeneidade na abordagem sobre saúde coletiva e um predomínio da metodologia tradicional nos currículos, o que favorece uma fragmentação do conhecimento. Na análise da formação, atuação e produção docente foi possível visualizar a existência de docentes que não possuíram uma formação pós-graduada em saúde coletiva e que publicam artigos na área da clínica fonoaudiológica. Adicionalmente, é possível perceber a existência de diferenças no perfil de formação e atuação dos docentes quando se analisa essa realidade nas regiões do país, sendo a região Nordeste a que possui mais docentes com formação, atuação e publicação na área da saúde coletiva. Conclusões: Na região Nordeste, apesar da saúde coletiva cumprir o papel de problematizar e inserir a formação do fonoaudiólogo no contexto do SUS, necessita-se da superação da lógica fragmentada na formação dos estudantes, de tal forma que outros componentes curriculares também sejam corresponsáveis pela constituição de profissionais com o perfil para atuação no SUS. Adicionalmente, no contexto nacional, a identificação da existência de docentes que são responsáveis por componentes de saúde coletiva, mas não possuem formação e publicação nessa área, alerta para uma consequente fragilização da saúde coletiva na fonoaudiologia (AU).
Introduction: The public health is constituted as a field of knowledge that aims to understand health and explain its social determinants, and the scope of practices aimed primarily at promoting it. Due to its characterization, public health is a field that has the potential to contribute to the reorientation of health practices of different health professions, such as speech-language-hering sciences. In Brazil, the speech-language-hearing therapists practice focused on school health, between the 1920s and 1940s, with practices based on health pedagogization and medicalization of education. Between 1950 and 1970, it directed it's work to private offices and rehabilitation clinics. In the 1990s, with the recently created Unified Health System (SUS), public gaps were identified in the performance of the speech-languagehearing therapist, beginning studies to rethink their training in the health context. Purpose: To analyze public health training in speech-language-hearing undergraduate programs at public Higher Education Institutions (HEIs) in the Northeast. Method: For the production of the data, interviews were conducted with key informants, students and professors from seven public HEIs in the Northeast. The interviews were recorded, transcribed, categorized and analyzed through Content Thematic Analysis. In addition, a documentary analysis of the lattes curricula of the speech-language-hearing teachers responsible for the public health curricular components in the Brazilian public HEIs was identified using the "snowball" technique. This analysis allowed to characterize of the training, performance and publication of these teachers. The data produced were organized in IBM SPSS software version 20, generating descriptive statistics, and correspondence analysis was performed. Results: It was identified in the analysis of the students' interviews that they have training experiences in public health that favor learning in SUS, but that have weaknesses in interprofessionality and in the integration of content. In the interviews with teachers, it was observed that speech-languagehearing undergraduate programs have a heterogeneous approach to public health and a predominance of traditional methodology in curriculum, which favors a fragmentation of knowledge. In the analysis of the teacher education, performance and production characterization, it was possible to visualize the existence of teachers who did not have postgraduate training in public health and who publish articles in the field of speechlanguage-hearing clinic. In addition, it is also possible to notice the existence of differences in the characterization of training and performance of teachers when analyzing this reality in the regions of the country, with the Northeast region having the most teachers with training, performance and publication in the area of public health. Conclusions: In the Northeast region, although public health problematizing and inserting the training of speech-languagehearing therapist in the context of the SUS, it is necessary to overcome the fragmented logic in the training of students, so that other curricular components are also co-responsible for the constitution of professionals with the profile to work in the SUS. Additionally, in the national context, the identification of the existence of professors who are responsible for public health components, but who do not have training and publication in this area, alerts to a consequent weakening of public health in speech-language-hearing science (AU).
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Universities , Unified Health System , Educational Measurement , Speech, Language and Hearing Sciences/education , Qualitative Research , Workforce , Document AnalysisABSTRACT
Objective:To analyze the work stress of medical staff at different medical institutions in Shanghai under the background of normalized prevention and control of 2019 novel coronavirus diseases(COVID-19), for evidence of relieving the work stress of medical staff.Methods:From September to November 2020, two community health service centers, one secondary hospital and one tertiary hospital were selected from each district of Jing′an District, Jiading District and Pudong New Area of Shanghai, totaling 12 medical institutions. The medical staff were selected by stratified random sampling. A self-designed questionnaire was used to conduct an online questionnaire survey on the work stress of medical staff. The survey data were analysied by descriptive analysis, and different groups were compared with chi square test.Results:1 422 valid questionnaires were obtained. There was a significant difference in self-rated routine work stress of medical staff between community health service centers and secondary/tertiary hospitals( P<0.001). The proportions of medical staff whose self-rated routine work stress was " quite stressed" or " very stressed" at community health service centers and secondary/tertiary hospitals were 39.77%(317)and 55.36%(346)respectively. There was a significant difference in self-rated COVID-19 prevention stress of medical staff between community health service centers and secondary/tertiary hospitals( P<0.001), the proportions of medical staff who considered the COVID-19 prevention was " quite stressed" or " very stressed" were 86.45%(689)and 76.48%(478)respectively. Conclusions:The overall work stress of medical staff at medical institutions in Shanghai was high.The prevention and control of COVID-19 increased the pressure of medical staff at all levels of medical institutions.
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Objective:To understand the current situation of appeals for rights and interests of medical staff in community health institutions and secondary/tertiary hospitals in Shanghai, for the suggestions on improving the job satisfaction and enthusiasm of medical staff.Methods:From September to November 2020, two community health service centers(stations), one secondary hospital and one tertiary hospital were selected from Jiading District, Pudong New Area and Jing′an District of Shanghai respectively. An online questionnaire survey was conducted among medical staff in medical institutions selected by stratified random sampling. The survey covered the main demographic information as well as 12 rights and interests demands, namely " salary promotion" among other. Descriptive analysis was performed on the data, and chi square test was used for comparison between groups.Results:1 759 valid questionnaires were recovered in this survey, and 1 654 medical employees(94.03%)reported a high degree of appeal for " salary promotion" . Compared with the medical staff in community health service centers(stations), the medical staff in secondary/tertiary hospitals reported higher demands for " training and study" " title appointment" and " academic promotion" , presenting a difference statistically significant( P<0.05). There were significant differences between doctors and nurses in " routine expense reimbursement" " staff recruitment" " professional title appointment" " children′s education" " cultural and recreational activities" and " opinion feedback channels" ( P<0.05). Conclusions:Salary promotion was the common demand of medical staff at all levels of medical institutions. Medical staff at secondary/tertiary hospitals had higher demands for career development. There were some differences in appeals for rights and interests between doctors and nurses. Medical institutions at all levels should continue to promote the reform of salary system, pay attention to the respective rights and interests of doctors and nurses, and improve their job satisfaction and enthusiasm.
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The in-depth advancement of the new era reforms such as new urbanization and rural revitalization strategies has transformed the characteristics and resource structure of rural villages. The traditional village health resources allocation models based on administrative divisions needed to evolve and achieve fair allocation and higher efficiency, and better meet the needs of rural primary health services. The authors sorted out the current status of village health resources allocation models. Based on such concepts as regional integration, and such key elements as demographics, population, health needs and information technology, the authors proposed the village-level health resources allocation model and selection strategy, under the three regional integration theories of township-village integration, village-area integration, and village leadership assistance. Their efforts aim at providing new perspectives for better protection and promotion of health of rural residents.
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Objective:To analyze the changes in the number and workload of pediatricians, for evidences in further optimizing the allocation of pediatrician resources and formulating relevant policies in China.Methods:According to data from the National Bureau of Statistics and the " China Health and Health Statistics Yearbook", descriptive analysis was made to investigate the changes in the number and workload of pediatricians in China from 2010 to 2019.Results:During 2010 and 2019, the number of pediatric practitioners(assistants) increased from 115 800 to 158 500, and the growth rate was faster than that of the children aged 0-14 years, but slower than that of overall medical practitioners(assistants). The number of pediatric practitioners(assistants) per thousand children in China had grown steadily from 0.52 to 0.67, compared with the burden and the workload of medical practitioners nationwide, the workload of pediatricians was still relatively heavy.Conclusions:The number of pediatricians had increased gradually between 2010 and 2019, and the effects of various policies began to work, while the workload was still heavy. It is recommended to further develop a salary system and supporting policies in line with the characteristics of pediatrics sector, and focus on such problems as unbalanced and inadequate distribution of pediatricians.
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Medical record information is the core data source for diagnosis related groups(DRG)payment, and high-quality of medical record information is the foundation for DRG payment. The development of medical record management towards medical record information management, pushes up the demand for high-quality medical record information management professionals in hospitals. The conventional practice of professional training had resulted in such setbacks as professionals mismatch, long pre-employment training period, and large demand for continuing education. Based on the triple helix model theory, the study established a production-education integration training mode of university-government-hospital for medical record information management professionals. Capacity development was set as the goal and job demand as the guidance, for effectively integrating the educational resources, and promoting the model of " posts linked to training, employment following graduation" production-education integration training. The aim is to expand the quantity of talent team and improve the quality of talent training, thus effectively easing the shortage of medical record information management professionals.