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医疗卫生劳动力市场的动态变化。

The dynamics of the health labour market.

作者信息

Vujicic Marko, Zurn Pascal

机构信息

Health, Nutrition and Population, Human Development Network, The World Bank, Washington, DC 20433, USA.

出版信息

Int J Health Plann Manage. 2006 Apr-Jun;21(2):101-15. doi: 10.1002/hpm.834.

Abstract

One of the most important components of health care systems is human resources for health (HRH)--the people that deliver the services. One key challenge facing policy makers is to ensure that health care systems have sufficient HRH capacity to deliver services that improve or maintain population health. In a predominantly public system, this involves policy makers assessing the health care needs of the population, deriving the HRH requirements to meet those needs, and putting policies in place that move the current HRH employment level, skill mix, geographic distribution and productivity towards the desired level. This last step relies on understanding the labour market dynamics of the health care sector, specifically the determinants of labour demand and labour supply. We argue that traditional HRH policy in developing countries has focussed on determining the HRH requirements to address population needs and has largely ignored the labour market dynamics aspect. This is one of the reasons that HRH policies often do not achieve their objectives. We argue for the need to incorporate more explicitly the behaviour of those who supply labour--doctors, nurses and other providers--those who demand labour, and how these actors respond to incentives when formulating health workforce policy.

摘要

卫生保健系统最重要的组成部分之一是卫生人力资源(HRH)——提供服务的人员。政策制定者面临的一个关键挑战是确保卫生保健系统拥有足够的卫生人力资源能力,以提供能够改善或维持民众健康的服务。在一个以公共系统为主的体系中,这要求政策制定者评估民众的卫生保健需求,确定满足这些需求所需的卫生人力资源,以及制定政策,使当前的卫生人力资源就业水平、技能组合、地理分布和生产力朝着理想水平发展。最后这一步依赖于了解卫生保健部门的劳动力市场动态,特别是劳动力需求和劳动力供给的决定因素。我们认为,发展中国家传统的卫生人力资源政策侧重于确定满足民众需求所需的卫生人力资源,而在很大程度上忽视了劳动力市场动态这一方面。这就是卫生人力资源政策往往无法实现其目标的原因之一。我们主张,在制定卫生人力政策时,需要更明确地纳入劳动力供给方(医生、护士和其他提供者)的行为、劳动力需求方的行为,以及这些行为主体如何对激励措施做出反应。

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