中国中小学校医队伍建设现状

张圣捷; 周蒙; 龚曦; 胡丹

doi:10.16835/j.cnki.1000-9817.2021.12.034

中国中小学校医队伍建设现状

doi: 10.16835/j.cnki.1000-9817.2021.12.034

张圣捷¹,
周蒙²,
龚曦¹,
胡丹^3, ,

1.
中国人民大学公共管理学院, 北京 100872
2.
青岛市市立医院
3.
北京大学中国卫生发展研究中心

详细信息

作者简介:
张圣捷(1994-), 女, 北京市人, 在读博士, 主要研究方向为健康教育与健康促进、卫生政策评估

通讯作者:
胡丹, E-mail: hudan@bjmu.edu.cn

中图分类号: G478 R192
计量
- 文章访问数: 1152
- HTML全文浏览量: 332
- PDF下载量: 98
- 被引次数: 0
出版历程
- 收稿日期: 2021-06-28
- 修回日期: 2021-10-15
- 网络出版日期: 2021-12-23
- 刊出日期: 2021-12-25

Current status of school doctor personnel in primary and secondary schools in China

1.
School of Public Administration and Policy, Renmin University of China, Beijing (100872), China

摘要

摘要: 目的分析《学校卫生工作条例》实施以来中国学校校医队伍建设现状，为引发对中小学校医管理制度的思考提供依据。方法在中国东、中、西部选择有代表性的省份(江苏、山东、江西、河北、青海、陕西)，通过定量研究和定性访谈进行混合方法研究。结果具有医学背景的校医占比为33.64%，部分校医(31.6%)尚未落实编制。校医在学校中地位较低，在收入、奖金分配、评优等方面较一线教师差距大，校医工资水平远低于教育行业和社会卫生保障福利业工资水平，有些地区甚至低于当地社会平均工资。薪酬水平呈现地域间不平衡，东部地区薪酬水平较高，中西部除个别地区，整体薪酬水平低。医学背景校医与非医学背景校医在最高学历、年收入水平、工作性质、是否在编、职业发展机会、收入满意度、福利待遇满意度和培训满意度之间差异均有统计学意义(χ²值分别为10.73，26.64，313.44，14.13，29.14，13.22，12.97，19.44，P值均 < 0.05)。结论需充分重视中小学校医队伍建设，将学校卫生纳入公共卫生管理体系，划分校医管理主体，规范校医务室工作办法，畅通校医人事薪酬及职称晋升通道。
- 卫生人员 /
- 组织和管理 /
- 公共卫生 /
- 中小学卫生保健服务
Abstract: Objective This study analyzes the development of school doctor personnel since the implementation of the national "School Health Work Regulations", from the salary of school doctors, followed by the management system of school doctors in primary and middle schools. Methods Representative provinces in the eastern, central and western regions of China were selected and surveyed through quantitative and qualitative method. Results The proportion of school doctors with medical background accounted for 33.64%, 31.6% school doctors had t o be established. A huge gap between income, bonus distribution and appraisal exsited between school doctors and school teachers. Wages of school doctors was much lower than that of education-and social health-sectors. The salary level showed regional imbalance, relatively higher in the eastern region and lower in the in the central and western regions with few exceptions. There were significant differences between medical background school doctors and non-medical background school doctors in the highest educational background, income level, job nature, job placement, career development opportunity, income satisfaction, welfare and training satisfaction(χ²=10.73, 26.64, 313.44, 14.13, 29.14, 13.22, 12.97, 19.44, P < 0.05). Conclusion Government needs to pay attention to the school doctors in primary and secondary schools, integreate school health into public health management system. Relevant policies regarding school doctor management authority, school clinic and health center guideline, salary standards, as well as professional career development, are expected.
- Health presonnel /
- Organization and administration /
- Public health /
- School health services

HTML全文

表 1 不同省份校医非工资性薪酬状况

Table 1. Non-wage salary of survey respondents in each province

省份	人数	养老保险	城镇职工基本医疗保险	工伤保险	失业保险	生育保险	住房补贴	交通补贴	子女教育优惠政策	其他	无
河北	131	107(81.7)	95(72.5)	90(68.7)	83(63.4)	59(45.0)	75(57.3)	3(2.3)	10(7.6)	11(8.4)	11(8.4)
江苏	132	128(97.0)	126(95.5)	98(74.2)	101(76.5)	96(72.7)	103(78.0)	86(65.2)	24(18.2)	9(6.8)	1(0.8)
江西	47	39(83.0)	35(74.5)	27(57.4)	32(68.1)	31(66.0)	18(38.3)	5(10.6)	2(4.3)	2(4.3)	7(14.9)
青海	50	43(86.0)	45(90.0)	30(60.0)	41(82.0)	18(36.0)	35(70.0)	23(46.0)	2(4.0)	0	2(4.0)
山东	103	95(92.2)	91(88.3)	61(59.2)	67(65.0)	64(62.1)	82(79.6)	10(9.7)	11(10.7)	3(2.9)	5(4.9)
陕西	75	65(86.7)	63(84.0)	17(22.7)	48(64.0)	5(6.7)	32(42.7)	0	2(2.7)	6(8.0)	5(6.7)
合计	538	477(88.7)	455(84.6)	323(60.0)	372(69.1)	273(50.7)	345(64.1)	127(23.6)	51(9.5)	31(5.8)	31(5.8)
注： “其他”选项在问卷中为填空题，填答结果包括年节福利和住房公积金；( )内数字为报告率/%。

下载: 导出CSV

表 2 不同组别医学背景与非医学背景校医分布比较

Table 2. Comparison of distribution of school doctors with different medical background and non-medical background

组别		医学背景(n=180)	非医学背景(n=358)	χ²值	P值
最高学历	高中	2(1.1)	4(1.1)	10.79	0.03
	中专	15(8.3)	11(3.1)
	大专	66(36.7)	112(31.3)
	本科	95(52.3)	222(62.0)
	研究生	2(1.1)	9(2.5)
技术职称	无职称	26(14.4)	50(14.0)	3.83	0.28
	初级	62(34.4)	98(27.4)
	中级	85(47.2)	188(52.5)
	副高	7(3.9)	22(6.1)
收入水平/元	1 001~2 000	28(15.6)	20(5.6)	26.64	< 0.01
	2 001~3 000	31(32.3)	68(19.0)
	3 001~4 000	36(20.0)	132(36.9)
	> 4 000	85(47.2)	138(38.6)
工作性质	兼职	34(18.9)	336(93.9)	313.44	< 0.01
	专职	146(81.1)	22(6.2)
有无编制	有	104(57.8)	264(73.7)	14.13	< 0.01
	无	76(42.2)	94(26.3)
职业发展(晋升、提拔等)机会	很少或没有	21(11.7)	15(4.2)	29.14	< 0.01
	较少	39(21.7)	34(9.5)
	一般	79(43.9)	195(54.5)
	较多	33(18.3)	91(25.4)
	很多	8(4.4)	23(6.4)
收入满意度	非常不满意	17(9.4)	14(3.9)	13.22	0.01
	不满意	32(17.8)	53(14.8)
	一般	75(41.7)	199(55.6)
	比较满意	51(28.3)	81(22.6)
	非常满意	5(2.8)	11(3.1)
福利待遇满意度	非常不满意	11(6.1)	11(3.1)	12.97	0.01
	不满意	22(12.2)	35(9.8)
	一般	78(43.3)	207(57.8)
	比较满意	61(33.9)	85(23.7)
	非常满意	8(4.4)	20(5.6)
培训机会满意度	非常不满意	7(3.9)	8(2.2)	19.44	< 0.01
	不满意	13(7.2)	32(8.9)
	一般	52(28.9)	168(46.9)
	比较满意	86(47.8)	122(34.1)
	非常满意	22(12.2)	28(7.8)
注： ( )内数字为构成比/%。

下载: 导出CSV

参考文献(18)

[1]	DEVORE D L, WHEELER L. Role of the school physician[J]. Pediatrics, 2013, 131(1): 178-182. doi: 10.1542/peds.2012-2995
[2]	Council on School Health. Role of the school nurse in providing school health services[J]. Pediatrics, 2008, 121(5): 1052-1056. doi: 10.1542/peds.2008-0382
[3]	TARAS H, BRENNAN J J. Students with chronic diseases: nature of school physician support[J]. J Sch Health, 2008, 78(7): 389-396. doi: 10.1111/j.1746-1561.2008.00319.x
[4]	ABOU K J, IBRAHIM M I, MOUSSA R F. Impact of epilepsy training on school teachers and counselors: an intervention study in Lebanon[J]. Epilepsy Behav Rep, 2020, 14: 100365. doi: 10.1016/j.ebr.2020.100365
[5]	LU M, ZHOU Y, CHEN X, et al. Knowledge, attitude and professional self-efficacy of Chinese mainstream primary school teachers regarding children with autism spectrum disorder[J]. Res Autism Spectr Disord, 2020, 72: 101513. doi: 10.1016/j.rasd.2020.101513
[6]	张河川. 云南省学校健康促进的效果评价[J]. 中国公共卫生, 2004, 20(10): 1276-1277. ZHANG H C. Evaluation of the effect of school health promotion in Yunnan Province[J]. Chin J Public Health, 2004, 20(10): 1276-1277.
[7]	马迎华, 胡芳, 吕晓静. 中小学学校卫生专业人员配备标准分析[J]. 中国学校卫生, 2011, 22(7): 771-773. doi: 10.16835/j.cnki.1000-9817.2021.07.030 MA Y H, HU F, LYU X J. Analysis on the staffing standard of health professionals in primary and secondary schools[J]. Chin J Sch Health, 2011, 22(7): 771-773. doi: 10.16835/j.cnki.1000-9817.2021.07.030
[8]	周亚平, 管仲军. 北京市中小学校医胜任力现状及影响因素分析[J]. 职业与健康, 2021, 37(9): 1260-1265. ZHOU Y P, GUAN Z J. Analysis of the current status and influencing factors of medical competence in primary and secondary schools in Beijing[J]. Occup Health, 2021, 37(9): 1260-1265.
[9]	屈芳, 邹享玉, 张云燕, 等. 岳阳市区中小学生2013年健康状况调查分析[J]. 湖南师范大学学报(医学版), 2016, 13(1): 147-150. QU F, ZOU X Y, ZHANG Y Y, et al. Investigation and analysis of the health status of primary and middle school students in Yueyang urban area in 2013[J]. J Hunan Normal Univ(Med Ed), 2016, 13(1): 147-150.
[10]	中共中央国务院. 中华人民共和国国民经济和社会发展第七个五年计划(1986—1990)[M]. 北京: 人民出版社, 1983. Central Committee of the Communist Party of China, State Council. Major indicators of economic and social development during the 7th Five-Year Plan Period of the People's Republic of China (1986-1990)[M]. Beijing: People's Publishing House, 1983.
[11]	国家教育委员会, 卫生部. 学校卫生工作条例[EB/OL]. (1990-06-04)[2020-12-25]. http://www.gov.cn/zhengce/2020-12/25/content_5574078.htm. The Ministry of Education of the People's Republic of China, Ministry of Health. Regulations on School Health Work[EB/OL]. (1990-06-04)[2020-12-25]. http://www.gov.cn/zhengce/2020-12/25/content_5574078.htm.
[12]	王智勇, 李宏斌, 李雪, 等. 关于对《学校卫生工作条例》部门职责修改的建议[J]. 预防医学论坛, 2011, 17(11): 1067-1069. WANG Z Y, LI H B, LI X, et al. Suggestions on the revision of the "School Health Regulations" departmental duties[J]. Prev Med Forum, 2011, 17(11): 1067-1069.
[13]	颜海娜, 聂勇浩. 食品安全监管合作困境的机理探究: 关系合约的视角[J]. 中国行政管理, 2009(10): 25-29. YAN H N, NIE Y H. The mechanism of food safety supervision cooperation dilemma: the perspective of relational contracts[J]. Chin Public Admin, 2009(10): 25-29.
[14]	段星. 海淀区中小学校校医激励机制优化研究[D]. 北京: 北京交通大学, 2012. DUAN X. Research on the optimization of the incentive mechanism of school doctors in primary and secondary schools in Haidian District[D]. Beijing: Beijing Jiaotong University, 2012.
[15]	王淑香, 李静. 北京市海淀区中小学卫生保健人员现状分析[J]. 中国学校卫生, 2005, 26(8): 698-699. doi: 10.3969/j.issn.1000-9817.2005.08.051 WANG S X, LI J. Analysis of the status of health care personnel in primary and secondary schools in Haidian District, Beijing[J]. Chin J Sch Health, 2005, 26(8): 698-699. doi: 10.3969/j.issn.1000-9817.2005.08.051
[16]	胡丹, 陈楚康, 张超, 等. 农村订单定向医学生免费培养政策实施现状调查[J]. 中国卫生政策研究, 2016, 9(9): 60-64. doi: 10.3969/j.issn.1674-2982.2016.09.011 HU D, CHEN C K, ZHANG C, et al. Investigation on the implementation status of free training policy for rural order-oriented medical students[J]. Chin J Health Policy, 2016, 9(9): 60-64. doi: 10.3969/j.issn.1674-2982.2016.09.011
[17]	刘晓云. 吸引和留住农村卫生人力的国际经验及启示[J]. 中国卫生政策研究, 2012(10): 37-42. LIU X Y. International experience and enlightenment of attracting and retaining rural health manpower[J]. Chin J Health Policy, 2012(10): 37-42.
[18]	仇元营, 余小鸣, 张芯, 等. 我国中小学校专职校医配备现状[J]. 中国学校卫生, 2014, 35(11): 1746-1748. http://www.cjsh.org.cn/article/id/zgxxws201411050 QIU Y Y, YU X M, ZHANG X, et al. The current situation of the provision of full-time school doctors in primary and secondary schools in China[J]. Chin J Sch Health, 2014, 35(11): 1746-1748. http://www.cjsh.org.cn/article/id/zgxxws201411050