2010年世卫组织全球行为准则发布后,医生移民和密度的变化
Tarun Ramesh1,2, Joia S Mukherjee3,4, Fang Zhang2
1Department of Medicine, Massachusetts General Hospital, Boston.
JAMA health forum
|February 6, 2026
概括
世界卫生组织 (WHO) 规范将医生从缺乏国家的移民减少了近30%. 然而,这些国家的医生密度并没有改善,这表明世卫组织守则对全球健康公平的影响是不同的.
科学领域:
- 全球健康 全球健康
- 卫生工作人员政策 卫生工作人员政策
- 国际移民 国际移民
背景情况:
- 从低收入和中等收入国家 (LMICs) 到高收入国家的医生移民加剧了全球卫生不平等.
- 世界卫生组织 (WHO) 于2010年制定了"关于国际招聘卫生人员的全球行为准则" (WHO准则),以解决这一问题.
- 世卫组织守则旨在通过阻止积极招聘和促进劳动力投资,减少来自世卫组织指定短缺国家的移民.
研究的目的:
- 评估世卫组织守则对来自世卫组织指定的短缺国家医生移民趋势的影响.
- 评估世卫组织守则实施后,这些国家内医生密度的变化.
主要方法:
- 一个差异设计分析了2000-2021年医生流出和密度数据.
- 来自56个被世卫组织指定为短缺国家的数据与116个非短缺国家的数据进行了比较.
- 医生迁移到经合组织国家和医生密度 (每1000人) 分别是主要和次要结果.
主要成果:
- 从世卫组织指定的短缺国家出境的医生流出,在2010年之后,每年平均每国减少47.03名医生,减少了近30%.
- 尽管移民减少了,但与非短缺国家相比,短缺国家的医生密度略有下降 (每1000人中有0.22名医生).
- 在2000年至2021年期间,共有135,888名医生从短缺国家移民.
结论:
- 世卫组织守则的自愿实施与从缺乏国家的医生外流显著减少有关.
- 然而,世卫组织守则并没有导致这些国家的医生密度有所改善.
- 可能需要进一步的策略来提高医生保留率,并改善全球卫生工作人员的分布.
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