我国全科医生队伍建设十年回望——基于Donabedian模型的分析
Ten-year Retrospective of General Practitioner Team Construction in China：an Analysis Based on the Donabedian Model
背景 全科医生是我国在建设初级卫生保健系统和实施“健康中国”战略进程中不可或缺的重要部分，近十年来我国全科医生队伍发展迅猛。目的 以 2012—2022 年（近十年）为研究跨度，总结我国全科医生队伍建设的经验成果，分析其存在的困难和不足，为后续我国的全科医生队伍建设提供参考。方法 借助 Donabedian 模型，依据 SMART 原则，选用政策支持、资金投入、基地建设作为结构设计环节的评价指标，从住院医师规范化培训（简称规培）与转岗、中西部全科医生队伍建设两个视角关注过程质量，以队伍规模、结构组成、工作满意度、离职意愿、职业发展机会作为效果评价环节的主要分析维度。研究资料主要源于中国政府网站、中国知网及 2012—2022 年卫生健康统计年鉴，中国政府网站和中国知网的检索时限设置为 2012-01-01—2022-12-31。结果 近十年我国全科医生队伍建设结构设计不断优化完善，资金投入、基地建设等配套措施紧密落实；过程环节政策端以动态调整回应现实需要，规培与转岗相关制度规范性稳步提高，中西部地区全科医生队伍建设逐年加强；队伍建设效果的区域差异尚存，部分问题尚待解决。结论 现有全科医生人力资源统计数据无法准确衡量我国全科医生队伍的人力供给情况，队伍稳定性建设有待进一步完善，差异的统筹协调相关研究有待深入。建议持续推进以提升职业吸引力为着力点的全科医生队伍稳定性建设，提高培养、就业、职业发展全周期各环节稳定性，多方合力共促全科医生队伍稳定性达成。
BackgroundGeneral practitionersGPs are an indispensable part of primary health care system in China and the implementation of the "Healthy China" strategy. In the past decadethe number of GPs in China has developed rapidly. ObjectiveTo summarize the experience and achievements of GP team construction from 2012 to 2022nearly ten yearsanalyze the existing difficulties and deficienciesand provide reference for the subsequent construction of GP team in China. MethodsWith the help of Donabedian modelpolicy supportcapital investment and base construction were selected as the evaluation indicators of structural design process based on the SMART principlethe process quality was focused from two perspectives of standardized training of residentsreferred to as standardized training and job transferthe construction of GP team in central and western China. The team sizestructurejob satisfactionresignation intention and career development opportunity were considered as the main analysis dimensions. The data were mainly obtained from Chinese government website and CNKI from 2012-01-01 to 2022-12-31as well as Health Statistical Yearbook 2012—2022. ResultsIn the past decadethe structural design of the construction of GP team in China has been continuously optimized and improvedand the supporting facilities such as capital investment and base construction have been closely implemented. The policy end of process has responded to the practical needs with dynamic adjustmentsthe standardization of relevant systems for standardized training and job transfer has steadily improvedand the construction of GP team in the central and western regions has been strengthened year by year. Regional differences in the effectiveness of team building still existand some problems need to be solved. ConclusionExisting human resource statistics on GP cannot accurately measure the human resource supply for GP team in Chinaand the construction of team stability needs to be further improved. It is recommended to continuously promote the stability construction of the GP team focusing on enhancing career attractivenessimprove the stability of the whole cycle of trainingemployment and career developmentand jointly promote the stability of GP team.
林瑾 、戴豪杰、朱雪波
医药卫生理论医学研究方法
全科医生卫生人力队伍建设质量评估职业满意职业发展onabedian 模型
林瑾 ,戴豪杰,朱雪波.我国全科医生队伍建设十年回望——基于Donabedian模型的分析[EB/OL].(2023-12-06)[2025-07-25].https://chinaxiv.org/abs/202312.00096.点此复制
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