Frenk-Mora J, Robledo-Vera C, Nigenda-López G, Ramírez-Cuadra C, Galván-Martínez O, Ramírez-Avila J
Departamento de Investigación en Recursos Humanos para la Salud, Instituto Nacional de Salud Pública, México.
Salud Publica Mex. 1990 Jul-Aug;32(4):440-8.
In this article we analyze education and employment policies for medical doctors in Mexico, which have led to a situation characterized by unemployment, under-employment and multiple-employment in urban areas, as well as lack of services in several rural zones. The analysis is divided into four defined periods according to the modes of State participation in health care: 1917-1958 (creation and slow growth of health care institutions); 1959-1967 (growth of scientific medicine); 1968-1979 (crisis period); and 1980-1988 (reform). In each one of these periods the evolution of medical manpower is analysed through the actions of three main actors: the State, the universities and the medical profession. The general conclusion of this historical analysis is that the present imbalance in the medical labor market has derived from a lack of joint planning of supply and demand, where by the educational and health care institutions, could decide together the crucial aspects of the quantity and quality of doctors that the population requires.
在本文中，我们分析了墨西哥针对医生的教育和就业政策，这些政策导致了城市地区出现失业、就业不足和多重就业的情况，同时一些农村地区也缺乏医疗服务。根据国家参与医疗保健的模式，该分析分为四个明确的时期：1917年至1958年（医疗保健机构的创建和缓慢发展）；1959年至1967年（科学医学的发展）；1968年至1979年（危机时期）；以及1980年至1988年（改革时期）。在每个时期，通过国家、大学和医学专业这三个主要行为体的行动来分析医疗人力的演变。这一历史分析的总体结论是，当前医疗劳动力市场的失衡源于供需缺乏联合规划，即教育机构和医疗保健机构未能共同决定民众所需医生数量和质量的关键方面。
