Status of health human resource and its influence on hierarchical medical service policy in Qinghai province

Objective To describe the status of health human resource in Qinghai province and to provide references for improvement of hierarchical medical service.Methods A face-to-face questionnaire survey was conducted among 880 medical professionals randomly selected from 55 health institutions other than village and community healthcare clinics in two municipalities and 6 ethnic autonomous prefectures in Qinghai province from September 2014 to January 2015.Results Of the 880 participants with eligible response, 61.2% were females and 20.7% were Tibetan;33.0% of medical professionals working in medical institutions at pastoral areas were Tibetan.Most of the professionals with graduate education worked in medical institutions in urban areas, whereas the majority of professionals working in grassroots institutions had university or college education.Totally 84.3% of the respondents expressed their positive evaluation on severity-based hierarchical medical service policy;the ratio of highly positive evaluation on the policy was significantly higher among the professionals in pastoral areas than among those in agricultural areas(χ²=11.89, P<0.01) and in urban areas(χ²=6.01, P<0.05) and the ratio of generally positive evaluation was also significantly higher among the professionals in pastoral areas than among those in urban areas(X2=5.67, P<0.05).Of all the professionals, 30.1% and 30.5% considered that the implementation of hierarchical medical service policy could solve the difficulty in visiting a doctor in large hospitals and reduce medication cost;there were 33.2%, 56.3%, and 10.5% of the professionals considering that individual proficiency has certain, great, and little influence on the implementation of hierarchical medical service, respectively;27.7% and 26.3% of the professionals in the institutions in agricultural and pastoral areas recognized ineffective utilization of medical facilities in grassroots medical institutions as the most important factor impeding local residents to select primary medical institution for seeking medical attention initially.Conclusion Insufficient health human resource and unbalanced allocation of the resource are import factors influencing the implementation of severity-based hierarchical medical service policy in Qinghai province.