Current situation and analysis of school physicians in primary and secondary schools in 16 provinces in China

Objective To analyze the status of school physicians in primary and secondary schools in China, and to provide possible reference for strengthening the school physician team in primary and secondary schools in China. Methods Investigated provinces were selected by stratified cluster sampling method according to China three major economic zones, 1 or 2 research centers were selected from each province above, all schools were surveyed in each research center. A total of 16 provinces, autonomous regions, and municipalities, 26 survey points and 10 027 primary and secondary schools were selected, and 6 466 schools which had a school size of more than 600 people or boarding schools were selected for analysis. Results For all schools, 33.1%(2 140 / 6 466) schools had at least one school physician, an average of 2 814.6 students shared 1 school physician and 5.0%(321 /6 466) schools with qualified number of school physicians. Multivariate logistic regression analysis showed that the equip rate of school physicians was affected by the economic zone, school type, school boarding system, school size, urban and rural factors(P<0.05). Compared with schools in the middle region, schools in the eastern region (OR= 3.30, 95%CI = 2.86-3.81) and west region (OR= 1.66, 95%CI = 1.40-1.96) with a higher probability in school physician equipment. Compared with primary schools, middle schools (OR= 2.06, 95%CI = 1.79-2.36) and high schools (OR= 7.93, 95%CI = 6.36-9.89) with a higher probability in school physician equipment; Boarding schools had a higher probability in school physician equipment than non-boarding schools(OR= 1.34, 95%CI = 1.11-1.61); Schools with students higher = 600 had a higher probability in school physician equipment than schools with students <600(OR= 1.72, 95%CI = 1.40-2.12); Compared with rural schools, schools in urban areas (OR = 2.79, 95%CI = 2.39-3.25) had a higher probability in school physician equipment. Conclusion School physicians in primary and secondary schools in China are not enough; there are significant differences between different economic development zones and different school types. The gaps in rural primary schools and small-sized boarding schools in the central and western regions are particularly serious. It is necessary to explore appropriate policies and strengthen the construction of school physician team.