Yongjun Zhang1,2, Lisu Huang1,2, Xin Zhou3, Xi Zhang3, Zheng Ke4, Zhaoxi Wang5, Qiang Chen6, Xiangyu Dong7, Lizhong Du8, Jianpei Fang9, Xing Feng10, Jianhua Fu11, Zhixu He12, Guoying Huang13, Songming Huang14, Xiuli Ju15, Li Gao16, Li Li17, Tingyu Li18, Yarui Li19, Geli Liu20, Wenjun Liu21, Xiaoping Luo22, Guangming Nong23, Jiahua Pan24, Kunling Shen25, Hongmei Song26, Jinghui Sun27, Dezhi Mu28, Tianyou Wang25, Baoxi Wang29, Wei Xiang30, Changyi Yang31, Shufen Yang32, Zhengyan Zhao8, Hua Zhu33, Yimin Zhu34, Jun Zhang2, Julian Little35, Therese Hesketh36,37, Kun Sun38,2. 1. Department of Pediatrics. 2. Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 3. Clinical Research Unit, and. 4. Shanghai MedSci Medical Institute, Shanghai, China. 5. Harvard Medical School, Harvard University and Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. 6. Department of Pediatrics, Jiangxi Provincial Children's Hospital, Nanchang, China. 7. Department of Pediatrics, Lanzhou University Second Hospital, Lanzhou, China. 8. Department of Pediatrics, The Children's Hospital and School of Medicine and. 9. Department of Pediatrics, Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. 10. Department of Pediatrics, Soochow University Affiliated Children's Hospital, Suzhou, China. 11. Department of Pediatrics, ShengJing Hospital of China Medical University, Shenyang, China. 12. Department of Pediatrics, The Affiliated Hospital of Guizhou Medical University, Guiyang, China. 13. Department of Pediatrics, Children's Hospital of Fudan University, Shanghai, China. 14. Department of Pediatrics, Children's Hospital of Nanjing Medical University, Nanjing, China. 15. Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China. 16. Department of Pediatrics, Henan Province People's Hospital, Zhengzhou, China. 17. Department of Pediatrics, First People's Hospital of Yunnan Province, Kunming University of Science and Technology, Kunming, China. 18. Department of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China. 19. Department of Pediatrics, Shanxi Children's Hospital and Shanxi Medical University, Taiyuan, China. 20. Department of Pediatrics, Tianjin Medical University General Hospital, Tianjin, China. 21. Department of Pediatrics, Affiliated Hospital of Southwest Medical University, Luzhou, China. 22. Department of Pediatrics, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 23. Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China. 24. Department of Pediatrics, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China. 25. Department of Pediatrics, Beijing Children's Hospital at Capital Medical University, Beijing, China. 26. Department of Pediatrics, Peking Union Medical College Hospital, Beijing, China. 27. Department of Pediatrics, The First Hospital of Jilin University, Changchun, China. 28. Department of Pediatrics, West China Women's and Children's Hospital, Chengdu, China. 29. Department of Pediatrics, Tangdu Hospital of the Fourth Military Medical University, Xian, China. 30. Department of Pediatrics, Maternal and Child Health Care Hospital of Hainan Province, Haikou, China. 31. Department of Pediatrics, Fujian Provincial Maternity and Children's Hospital of Fujian Medical University, Fuzhou, China. 32. Department of Pediatrics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. 33. Department of Pediatrics, Inner Mongolia Autonomous Region People's Hospital, Hohhot, China. 34. Department of Pediatrics, Hunan Province People's Hospital, Changsha, China. 35. School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Canada; and. 36. Institute for Global Health, Zhejiang University, Hangzhou, China. 37. Institute for Global Health, University College London, London, United Kingdom. 38. Department of Pediatrics, sunkun@xinhuamed.com.cn.
Abstract
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 54 214 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 135 524 pediatricians in China or ∼4 pediatricians per 10 000 children. Pediatricians' average educational level was low, with ∼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.
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 54 214 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 135 524 pediatricians in China or ∼4 pediatricians per 10 000 children. Pediatricians' average educational level was low, with ∼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.
Authors: Jiamin Wang; Peter C Coyte; Di Shao; Xuemei Zhen; Ni Zhao; Chen Sun; Xiaojie Sun Journal: Int J Environ Res Public Health Date: 2022-08-17 Impact factor: 4.614