Characteristics and Workload of Pediatricians in China

被引：90

作者：

Zhang, Yongjun ^{[1
,3
]}

Huang, Lisu ^{[1
,3
]}

Zhou, Xin ^{[2
]}

Zhang, Xi ^{[2
]}

Ke, Zheng ^{[4
]}

Wang, Zhaoxi ^{[5
,6
]}

Chen, Qiang ^{[7
]}

Dong, Xiangyu ^{[8
]}

Du, Lizhong ^{[9
,10
]}

Fang, Jianpei ^{[12
]}

Feng, Xing ^{[13
]}

Fu, Jianhua ^{[14
]}

He, Zhixu ^{[15
]}

Huang, Guoying ^{[16
]}

Huang, Songming ^{[17
]}

Ju, Xiuli ^{[18
]}

Gao, Li ^{[19
]}

Li, Li ^{[20
]}

Li, Tingyu ^{[21
]}

Li, Yarui ^{[22
,23
]}

Liu, Geli ^{[24
]}

Liu, Wenjun ^{[25
]}

Luo, Xiaoping ^{[26
]}

Nong, Guangming ^{[27
]}

Pan, Jiahua ^{[28
]}

Shen, Kunling ^{[29
]}

Song, Hongmei ^{[30
]}

Sun, Jinghui ^{[31
]}

Mu, Dezhi ^{[32
]}

Wang, Tianyou ^{[29
]}

Wang, Baoxi ^{[33
]}

Xiang, Wei ^{[34
]}

Yang, Changyi ^{[35
]}

Yang, Shufen ^{[36
]}

Zhao, Zhengyan ^{[9
,10
]}

Zhu, Hua ^{[37
]}

Zhu, Yimin ^{[38
]}

Zhang, Jun ^{[3
]}

Little, Julian ^{[39
]}

Hesketh, Therese ^{[11
,40
]}

Sun, Kun ^{[1
,3
]}

机构：

[1] Shanghai Jiao Tong Univ, Xinhua Hosp, Sch Med, Dept Pediat, 1665 Kongjiang Rd, Shanghai 200092, Peoples R China

[2] Shanghai Jiao Tong Univ, Xinhua Hosp, Sch Med, Clin Res Unit, Shanghai, Peoples R China

[3] Shanghai Jiao Tong Univ, Xinhua Hosp, Sch Med, Minist Educ,Shanghai Key Lab Childrens Environm H, Shanghai, Peoples R China

[4] Shanghai MedSci Med Inst, Shanghai, Peoples R China

[5] Harvard Univ, Harvard Med Sch, Boston, MA 02115 USA

[6] Beth Israel Deaconess Med Ctr, Dept Obstet & Gynecol, Boston, MA 02215 USA

[7] Jiangxi Prov Childrens Hosp, Dept Pediat, Nanchang, Jiangxi, Peoples R China

[8] Lanzhou Univ, Dept Pediat, Hosp 2, Lanzhou, Gansu, Peoples R China

[9] Zhejiang Univ, Childrens Hosp, Dept Pediat, Hangzhou, Zhejiang, Peoples R China

[10] Zhejiang Univ, Sch Med, Hangzhou, Zhejiang, Peoples R China

[11] Zhejiang Univ, Inst Global Hlth, Hangzhou, Zhejiang, Peoples R China

[12] Sun Yat Sen Univ, Affiliated Hosp 2, Dept Pediat, Guangzhou, Guangdong, Peoples R China

[13] Soochow Univ, Dept Pediat, Affiliated Childrens Hosp, Suzhou, Peoples R China

[14] China Med Univ, Dept Pediat, ShengJing Hosp, Shenyang, Liaoning, Peoples R China

[15] Guizhou Med Univ, Dept Pediat, Affiliated Hosp, Guiyang, Guizhou, Peoples R China

[16] Fudan Univ, Childrens Hosp, Dept Pediat, Shanghai, Peoples R China

[17] Nanjing Med Univ, Dept Pediat, Childrens Hosp, Nanjing, Jiangsu, Peoples R China

[18] Shandong Univ, Qilu Hosp, Dept Pediat, Jinan, Shandong, Peoples R China

[19] Henan Prov Peoples Hosp, Dept Pediat, Zhengzhou, Henan, Peoples R China

[20] Kunming Univ Sci & Technol, Peoples Hosp Yunnan Prov 1, Dept Pediat, Kunming, Yunnan, Peoples R China

[21] Childrens Hosp Chongqing Med Univ, Dept Pediat, Chongqing, Peoples R China

[22] Shanxi Childrens Hosp, Dept Pediat, Taiyuan, Shanxi, Peoples R China

[23] Shanxi Med Univ, Taiyuan, Shanxi, Peoples R China

[24] Tianjin Med Univ, Dept Pediat, Gen Hosp, Tianjin, Peoples R China

[25] Southwest Med Univ, Dept Pediat, Affiliated Hosp, Luzhou, Peoples R China

[26] Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Pediat, Wuhan, Hubei, Peoples R China

[27] Guangxi Med Univ, Dept Pediat, Affiliated Hosp 1, Nanning, Peoples R China

[28] Univ Sci & Technol China, Affiliated Hosp 1, Dept Pediat, Hefei, Anhui, Peoples R China

[29] Capital Med Univ, Dept Pediat, Beijing Childrens Hosp, Beijing, Peoples R China

[30] Peking Union Med Coll Hosp, Dept Pediat, Beijing, Peoples R China

[31] Jilin Univ, Dept Pediat, Hosp 1, Changchun, Jilin, Peoples R China

[32] West China Womens & Childrens Hosp, Dept Pediat, Chengdu, Sichuan, Peoples R China

[33] Fourth Mil Med Univ, Dept Pediat, Tangdu Hosp, Xian, Shaanxi, Peoples R China

[34] Maternal & Child Hlth Care Hosp Hainan Prov, Dept Pediat, Haikou, Hainan, Peoples R China

[35] Fujian Med Univ, Dept Pediat, Fujian Prov Matern & Childrens Hosp, Fuzhou, Fujian, Peoples R China

[36] Harbin Med Univ, Dept Pediat, Affiliated Hosp 2, Harbin, Heilongjiang, Peoples R China

[37] Inner Mongolia Autonomous Reg Peoples Hosp, Dept Pediat, Hohhot, Peoples R China

[38] Hunan Prov Peoples Hosp, Dept Pediat, Changsha, Hunan, Peoples R China

[39] Univ Ottawa, Sch Epidemiol Publ Hlth & Prevent Med, Ottawa, ON, Canada

[40] UCL, Inst Global Hlth, London, England

来源：

PEDIATRICS | 2019年 / 144卷 / 01期

关键词：

CHILD HEALTH-CARE; PHYSICIANS; CRISIS; FACE;

D O I：

10.1542/peds.2018-3532

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Through a national survey, we found that uneven development of the pediatric care system is the major challenge facing China's pediatric health care system. OBJECTIVES:Although it is widely believed that China is facing a major shortage of pediatricians, the real situation of the current national status of pediatric human resources and their working conditions has not been evaluated to date.METHODS:We administered a survey to 54214 hospitals from all 31 provinces in mainland China from 2015 to 2016. Hospital directors of all secondary and tertiary hospitals with pediatric services and a random sample (10%) of primary hospitals provided information on number of pediatricians and their educational levels, specialties, workloads, dropout rates, and other hospital characteristics. A data set of medical resources and socioeconomic information regarding each region (1997-2016) was constructed from the Chinese National Statistics Bureau. The Gini coefficient was used to describe the geographical distributions of pediatricians and hospitals.RESULTS:There were 135524 pediatricians in China or similar to 4 pediatricians per 10000 children. Pediatricians' average educational level was low, with similar to 32% having only 3 years of junior college training after high school. The distribution of pediatricians was extremely skewed (Gini coefficient 0.61), and the imbalance of highly educated pediatricians was even more skewed (Gini coefficient 0.68). The dropout rate of pediatricians was 12.6%. Despite an increase in the Chinese government's financial investment in health over the last decade, physicians have been burdened with a greater workload.CONCLUSIONS:Uneven development of the pediatric care system, inadequately trained pediatricians, low job satisfaction, and unmet demand for pediatric care are the major challenges facing China's pediatric health care system.

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