A survey on current status of clinicians in community health-care service centers of three cities in China

Abstract

Objective To understand current status and problems existed among clinicians workforce in several community health-care service centers of China to provide evidence for relevant policy-making. Methods Sixty-two community health-care service centers were selected from two districts each in Tianjin, Nanjing and Wuhan Cities, respectively, for the survey with questionnaire and focus group discussion. Results ①Fifty-eight of 62 community health-care service centers surveyed (93.5 percent) were qualified as a legal entity, 60 (96.8 percent) registered as medical insurance institutions designated by government, and 59 (95.2 percent) were state-owned or run by state-owned hospitals. All the 60 institutions provided service in public health and essential medical care for communities and were economically running relatively good. ②There were totally 1664 registered clinicians with an average age of 45 years ( and a standard deviation of 11 ), 942 of them ( 56.6 percent) at age above 45, 406 ( 24.4 percent) at age below 35, and 1166 (70.1 percent) with college education. ③Thirty-eight of 874 clinicians with medium or senior professional titles (4.4 percent) were qualified as general practitioners (GPs). ④Five hundred and thirty-eight of 1024 licensed clinicians or assistant clinicians (52.5 percent) were registered as internists for permit to practice medicine, and 65 registered as GPs (6.3 percent). There were totally 257 GPs in general practice clinics and 45 of them registered as GPs (17.5 percent) for permit to practice medicine. ⑤One hundred and five clinicians were promoted in the past three years and 17 of them were registered as GPs (16.2 percent). ⑥Three hundred and fifty-four clinicians were temporarily employed (21.3 percent) of those in service. Conclusions ①A lot of clinicians at general practice consultation rooms in community health-care service centers practiced medicine often beyond their duties registered. ②Few clinicians extended their willingness to be promoted as GPs, with too lower percentage of them taking promotion examinations. ③The number of GPs was in short obviously and quality of GPs was poor in general with their relatively older age.④It is suggested that more investment should be input, relevant policies perfected, attraction to GP position increased, human resource management and legal management of GPs strengthened, and non-registered practicing behavior should be eliminated by government. Key words: Community health center; Questionnaires; Interviews; General practitioner