Ethical Issues Analysis and Countermeasures Exploration of the Allocation of Rural Health Human Resource

Objective To investigate the ethical issues existed in the allocation of rural health human Resource in Beijing and then attempt to work out the countermeasures. Methods 75 administrative villages were selected from 25 villages and towns of 5 districts in Beijing by stratified sampling in May 2011. 5 kinds of stakeholders were investigated on site by questionnaire: hospital managers,medical staff,village doctors,villagers and village cadres and they were 1719 totally. At the same time,purpose sampling method was used to investigate 35 people including the insiders,district leaders in charge of health,health administrative department managers,village medical workers and villages. Results Township hospitals managers believed that the main problems facing the construction of hospitals personnel were: lack of qualified health personnel( 35 people); low welfare benefit attraction to excellent health personnel( 30 people); unreasonableness of professional staff structure( 22 people); deficiency in cultivating more talents suitable to rural areas( 22 people); serious loss of health technicians in middle age and youth and appearing the problem of break in talents( 18 people); mainly non- professional staff with low quality( 5 people) and so on. Township hospitals managers believed that the most suitable medical staff for the future hospitals were: from and to township college students through orientation training( 39 people); ordinary medical graduates( 34 people); counterpart support medical staff from higher medical institutions( 19 people); from to secondary school students through orientation training( 13 people) and so on. About the future village doctor candidates,according to the villagers,the top three were: doctors sent by upper health institutions( 562 people),secondary school students or collect graduates trained for rural areas( 546 people),the village people who understand medicine( 488 people);According to village doctors,the top three were: secondary school students or college graduates trained for rural areas( 46 people),technical school students trained for rural areas( 38 people),doctors sent by upper health institutions( 36 people).Conclusion The following ethical issues exist among the allocation of rural health human resource based on fair and feasible perspective: the different practice environment affects service behavior and service fairness and feasibility; admittance standard for rural health human resources affects the subsequent personnel complement and sustainable development of the team,and the diagnosis and treatment ability influences the farmers' awareness of health and flow direction. In response to these problems we should take the following measures: reasonable definition of the functional orientation of the village and town clinics to meet the differentiated needs of farmers,expansion of the new rural cooperative reimbursement coverage of village- level medical institutions to improve the allocation efficiency of rural health human resource,and establishment of the localized training system for rural health personnel to protect the effective supply of rural human resources.