新冠肺炎疫情下跨区域医疗人力资源的应急调度研究

Emergency dispatching of trans-regional medical human resources under COVID-19 epidemic

摘要:

目的 研究分析重大传染病流行事件下跨区域医疗人力资源应急调度管理模式，为医疗资源应急管理提供参考依据。 方法 采用单案例研究法，选取湖南省应急调度医疗人力资源抗击新冠肺炎疫情作为典型案例，描述分析援助武汉市、黄冈市，以及湖南省内市州的人力配置与队伍组建模式。 结果 湖南省共统筹安排14批次医疗队支援武汉市（461人）和黄冈市（619人），同时组建2个梯队共计225人的专家队伍指导省内医疗救治，跨区域医疗人力资源快速重组和再分配过程分为快速响应期、抗疫僵持期、抗疫决胜期、巩固恢复期四个阶段。湖南省13个市州共计94所卫生机构接受了统一调度，包括医疗机构86所（占比91.49%）、疾控中心8所（8.51%）；医疗机构以公立医院为主（占比96.51%）；援助武汉市和黄冈市的医疗人力资源以护士居多，占比分别为71.15%和66.56%，医疗队人员职称从初级到高级呈现"金字塔"结构；援助省内市州的以医生为主，占比为80.00%，绝大多数人员为高级职称，副高及以上职称占90.22%。根据区域医疗需求的不同，湖南省应急医疗队伍主要有7种类型以及托管和指导两类运行模式。 结论 湖南省跨区域医疗人力资源应急调度具有响应快速及时、资源投入充分、需求精准把握的特点，建议在经验总结的基础上进一步优化应急医疗队伍分级分类体系、应急人力资源储备体系、应急指挥调度体系。

Abstract:

Objective To analyze the emergency dispatching management mode of trans-regional medical human resources in the event of epidemic of major infectious diseases, provide reference for the emergency management of medical resources. Methods A single case study method was adopted, the emergency dispatching of medical human resources by Hunan Province to fight against COVID-19 epidemic was taken as a typical case, manpower allocation and team formation mode for assistance to Wuhan, Huanggang as well as various cities and municipalities in Hunan Province were described and analyzed. Results Hunan Province has arranged a total of 14 medical teams to support Wuhan (461 persons) and Huanggang (619 persons), at the same time, two echelons of expert teams (225 persons) have been set up to guide medical treatment in Hunan Province. The rapid re-organization and re-allocation process of trans-regional medical human resources was divided into four periods: rapid response period, anti-epide-mic stalemate period, anti-epidemic decisive period and consolidation recovery period. A total of 94 health institutions in 13 cities and municipalities of Hunan Province received unified dispatching, including 86 medical institutions (91.49%) as well as 8 centers for disease control and prevention (8.51%); medical institutions that received dispatching were mainly public hospitals (96.51%); the majority of medical human resources assisting in Wuhan and Huanggang were nurses, accounting for 71.15% and 66.56% respectively, the titles of medical team personnel showed a "pyramid" structure from junior to senior; the majority of the people who assisted the cities and municipalities in Hunan Province were clinicians, accounting for 80.00%, and most of them had senior professional titles, 90.22% had associate professional titles or above. According to medical needs of different regions, there were 7 types of emergency medical teams and 2 types of operation modes: trusteeship and guidance. Conclusion Trans-regional medical human resources emergency dispatching of Hunan Province is characterized by rapid and timely response, sufficient resource input and accurate grasp of demands. It is suggested to further optimize the classification system of emergency medical teams, emergency human resources reserve system as well as emergency command and dispatching system on the basis of experience summary.