在多次危机期间医疗保健劳动力分布:对土耳其医生分配,保留和公平模式的12年分析
Eray Ontas1, Cavit Işık Yavuz2
1Ankara University Faculty of Medicine Department of Public Health Division of Epidemiology, Ankara, Turkey.
Health policy (Amsterdam, Netherlands)
|December 18, 2025
概括
土耳其的医生分配系统显示,在外围地区的医生保留率很低,尽管人口密度增加,但不平等性恶化. 义务服役无法确保长期的公平性和性.
科学领域:
- 卫生政策 卫生政策
- 医疗卫生工作人员管理管理
- 公共卫生 公共卫生
背景情况:
- 全球卫生系统面临着影响劳动力弹性和公平性的危机.
- 土耳其的集中式医疗保健系统为检查连续冲击下的治理提供了一个模型.
研究的目的:
- 评估土耳其强制医生分配系统对长达十年的危机的反应.
- 引入一种新的指标来评估医生劳动力保留效率.
主要方法:
- 12年长度生态研究 (2013-2024) 使用卫生部医生数据.
- 开发了一个"保留效率"指标 (ΔStock/Flow) 来量化系统性能.
- 应用了准实验方法来分析叙利亚难民涌入,COVID-19和2023年地震的影响.
主要成果:
- 医生密度增加了57%,但区域不平等明显恶化 (加权-吉尼:+47%).
- 确定了一个"旋转门"的动态,在西部地区的高保留率和东部地区的严重低效率.
- 地震导致震中省份医生密度的"挥发性激增",而叙利亚难民涌入显示"综合吸收",没有有针对性的反应.
结论:
- 义务服役提供短期能力,但不是持续的股权.
- 保持效率指标揭示了密度指标所忽略的效率不足.
- 可持续的劳动力弹性需要超越强制性安置,以激励和专业生态系统投资.
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