Health System Reform in China 5 4 China's human resources for health: quantity, quality, and distribution
Health System Reform in China 5 4 China's human resources for health: quantity, quality, and distribution
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DOI：
10.1016/s0140-6736(08)61363-x
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发表时间：
2008-11-15
期刊：
影响因子：
168.9
通讯作者：
Chen, Lincoln C.
中科院分区：
文献类型：
--
作者：
Anand, Sudhir;Fan, Victoria Y.;Chen, Lincoln C.
本文从数量、质量和分布三个方面分析了中国卫生人力资源现状。与大多数国家不同，中国的医生比护士多--2005年，中国有190万执业医生和140万护士。城市地区的医生密度是农村地区的两倍多，护士密度则是农村地区的三倍多。中国大部分医生（67.2%）和护士（97.5%）的文化程度仅为大专或中专。自1998年以来，医学教育大规模扩展，卫生工作者的产出超过了卫生工作者的吸收。医生和护士分布的县间不平等程度很高，其中大部分不平等是省内不平等（82%或以上），而不是省与省之间的不平等。城乡之间医生和护士密度的差异约占整个县间不平等的三分之一。这些不平等对中国各县、省和各阶层的健康结果有很大影响;例如，使用2000年人口普查数据进行的跨县多元回归分析表明，卫生工作者的密度在解释婴儿死亡率方面非常重要。
in this paper, we analyse China's current health workforce in terms of quantity, quality, and distribution. Unlike most countries, China has more doctors than nurses-in 2005, there were 1.9 million licensed doctors and 1.4 million nurses. Doctor density in urban areas was more than twice that in rural areas, with nurse density showing more than a three-fold difference. Most of China's doctors (67.2%) and nurses (97.5%) have been educated up to only junior college or secondary school level. Since 1998 there has been a massive expansion of medical education, with an excess in the production of health workers over absorption into the health workforce. Inter-county inequality in the distribution of both doctors and nurses is very high, with most of this inequality accounted for by within-province inequalities (82% or more) rather than by between-province inequalities. Urban-rural disparities in doctor and nurse density account for about a third of overall inter-county inequality. These inequalities matter greatly with respect to health outcomes across counties, provinces, and strata in China; for instance, a cross-county multiple regression analysis using data from the 2000 census shows that the density of health workers is highly significant in explaining infant mortality.