ارزﯾﺎﺑﯽ ﺗﻮزﯾﻊ ﺟﻐﺮاﻓﯿﺎﯾﯽ ﭘﺰﺷﮑﺎن ﻋﻤﻮﻣﯽ و ﻣﺘﺨﺼﺺ ﺑﺮ ﺣﺴﺐ ﺟﻤﻌﯿﺖ و ﺷﺎﺧﺺﻫﺎي ﺗﻌﺪﯾﻞ ﻧﯿﺎز در اﺳﺘﺎن ﺧﺮاﺳﺎن رﺿﻮي

Geographical Distribution of General and Specialist Physicians per Population and Need Adjustment Indix in Khorasan Razavi Province

ﻣﻘﺪﻣﻪ ﺑﺮرﺳﯽ ﺗﻮزﯾﻊ ﺟﻐﺮاﻓﯿﺎﯾﯽ ﭘﺰﺷﮑﺎن در دﺳﺘﯿﺎﺑﯽ ﺑﻪ ﻋﺪاﻟﺖ اﺟﺘﻤﺎﻋﯽ و ﮐﺎﻫﺶ ﻧﺎﺑﺮاﺑﺮي ﺿﺮوري اﺳﺖ ﻟﺬا دراﯾﻦ ﻣﻄﺎﻟﻌﻪ وﺿﻌﯿﺖ ﺗﻮزﯾﻊ ﭘﺰﺷﮑﺎن، ﭘﺰﺷﮑﺎن ﻋﻤﻮﻣﯽ و ﻣﺘﺨﺼﺺ ﺑﺮﺣﺴﺐ ﺟﻤﻌﯿﺖ و ﺷﺎﺧﺺﻫﺎي ﺗﻌﺪﯾﻞ ﻧﯿﺎز در اﺳﺘﺎن ﺧﺮاﺳﺎن رﺿﻮي ﺑﺮرﺳﯽ ﺷﺪ. روش ﮐﺎر ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺗﻮﺻﯿﻔﯽ- ﻣﻘﻄﻌﯽ و ﮐﺎرﺑﺮدي اﺳﺖ و ﺟﺎﻣﻌﻪ آﻣﺎري ﺷﺎﻣﻞ ﭘﺰﺷﮑﺎن، ﭘﺰﺷﮑﺎن ﻋﻤﻮﻣﯽ، ﭘﺰﺷﮑﺎن ﻣﺘﺨﺼﺺ و ﻓﻮق ﺗﺨﺼﺺ ﺷﻬﺮﺳﺘﺎنﻫﺎي اﺳﺘﺎن ﺧﺮاﺳﺎن رﺿﻮي در ﺳﺎلﻫﺎي 1390 ،1385 و 1395 ﺑﻮد ﮐﻪ ﻧﻤﻮﻧﻪﮔﯿﺮي اﻧﺠﺎم ﻧﺸﺪ. دادهﻫﺎي ﻣﻮرد ﻧﯿﺎز از ﺳﺎﻟﻨﺎﻣﻪﻫﺎي آﻣﺎري ﻣﺮﮐﺰ آﻣﺎر اﯾﺮان اﺳﺘﺨﺮاج و ﺷﺎﺧﺺﻫﺎي ﺟﯿﻨﯽ و راﺑﯿﻦﻫﻮد ﺑﺮ اﺳﺎس ﺟﻤﻌﯿﺖ و ﺷﺎﺧﺺﻫﺎي ﻧﯿﺎز در ﻧﺮماﻓﺰارﻫﺎي Stata 14 و Excel 2019 اﻧﺠﺎم ﺷﺪ. ﻧﺘﺎﯾﺞ ﻧﺴﺒﺖ ﭘﺰﺷﮏ، ﭘﺰﺷﮏ ﻣﺘﺨﺼﺺ و ﻋﻤﻮﻣﯽ ﺑﻪ ازاي ده ﻫﺰار ﻧﻔﺮ در اﺳﺘﺎن ﺑﻪ ﺗﺮﺗﯿﺐ در ﺳﺎل 1395 ﺑﺮاﺑﺮ ﺑﺎ 2/12 ،5/08 و 1/84 ﺑﻮد ﮐﻪ ﻋﻠﯿﺮﻏﻢ رﺷﺪ ﺑﺎﻻ ﻧﺴﺒﺖ ﺑﻪ ﺳﺎلﻫﺎي ﻗﺒﻞ از ﻣﺘﻮﺳﻂ ﮐﻞ ﮐﺸﻮر ﮐﻤﺘﺮ ﺑﻮد. ﺿﺮﯾﺐ ﺟﯿﻨﯽ ﺑﺮاي ﭘﺰﺷﮏ، ﭘﺰﺷﮏ ﻣﺘﺨﺼﺺ و ﻋﻤﻮﻣﯽ ﺑﺮﺣﺴﺐ ﺟﻤﻌﯿﺖ در ﺳﺎل 1385 ﺑﻪ ﺗﺮﺗﯿﺐ ﺑﺮاﺑﺮ ﺑﺎ 0/13 ،0/38 و 0/71 ﺑﻮد ﮐﻪ در ﺳﺎل 1395 ﺑﻪ 0/06 ،0/24 و 0/69 ﮐﺎﻫﺶ ﯾﺎﻓﺖ ﻫﻤﭽﻨﯿﻦ ﺗﻮزﯾﻊ ﭘﺰﺷﮑﺎن و ﭘﺰﺷﮑﺎن ﻣﺘﺨﺼﺺ ﺑﺮ اﺳﺎس ﺷﺎﺧﺺﻫﺎي ﺗﻌﺪﯾﻞ ﻧﯿﺎز ﺑﺴﯿﺎر ﻧﺎﺑﺮاﺑﺮﺗﺮ از ﺷﺎﺧﺺ ﺟﻤﻌﯿﺖ ﺑﻮد. ﻧﺘﯿﺠﻪ ﮔﯿﺮي ﻧﺎﺑﺮاﺑﺮي ﭘﺰﺷﮏ، ﭘﺰﺷﮏ ﻣﺘﺨﺼﺺ و ﻋﻤﻮﻣﯽ ﺑﺮ ﺣﺴﺐ ﺟﻤﻌﯿﺖ ﮐﺎﻫﺶ ﯾﺎﻓﺖ ﻟﺬا ﭘﯿﺸﻨﻬﺎد ﻣﯽﺷﻮد در ﺑﻠﻨﺪﻣﺪت ﺳﯿﺎﺳﺖﻫﺎ و ﺑﺮﻧﺎﻣﻪﻫﺎﯾﯽ ﺟﻬﺖ اﻓﺰاﯾﺶ ﺗﻌﺪاد ﭘﺰﺷﮑﺎن از ﻃﺮﯾﻖ اﻓﺰاﯾﺶ ﺳﻬﻤﯿﻪ در داﻧﺸﮕﺎهﻫﺎ ﺟﻬﺖ ﺧﺪﻣﺖ ﻃﻮﻻﻧﯽﻣﺪت در اﺳﺘﺎن و ﻫﻤﭽﻨﯿﻦ ﺟﺬب ﭘﺰﺷﮑﺎن ﺑﺎ ﻣﺸﻮقﻫﺎي ﻻزم اﺗﺨﺎذ ﺷﻮد ﻫﻤﭽﻨﯿﻦ در ﮐﻮﺗﺎهﻣﺪت ﺗﻮزﯾﻊ ﻣﻮﻗﺖ ﭘﺰﺷﮑﺎن ﻣﺘﺨﺼﺺ و ﻓﻮق ﺗﺨﺼﺺ ﺑﯿﻦ ﺷﻬﺮﺳﺘﺎنﻫﺎي اﺳﺘﺎن ﭘﯿﺸﻨﻬﺎد ﻣﯽﮔﺮدد.

Introduction: geographical distribution of physicians is essential for achieving social justice and reducing inequality. In this study, the distribution of physicians, general practitioners and specialist according to population and need adjustment index in Khorasan Razavi province was investigated. Materials and Methods: This was descriptive, cross-sectional and applied study including all of physicians, general practitioners and specialist of Khorasan Razavi province in 2006, 2011 and 2016 that Sampling was not done. Data were extracted from the yearbooks of Statistical Center of Iran and Gini and Robin Hood indices based on population and need adjustment index were calculated in Stata 14 and Excel 2019 software. Results: The ratio of physician, specialist and general practitioners per 10000 population in the province was 5.08, 2.12 and 1.84, respectively, which was lower than the national average despite high growth. Gini coefficient for physician, specialist and general practitioner by population in 2006 was 0.38, 0.13 and 0.71 respectively, which decreased to 0.24, 0.06 and 0.69 in 2016, respectively. The distribution of physicians and specialist based on the need adjustment index was also more unequal than the population index. Conclusion: Inequality of physician, specialist and general practitioners per population has decreased, so it is recommended to adopt long-term policies and programs to increase the number of physicians by increasing the quota in universities for long-term service in the province as well as recruiting physicians with the necessary incentives. Also In the short term, it is recommended to distribute specialist between cities temporarily.