Anesthesia Workforce and Workload in China: A National Survey

Abstract

Background: With the economy growth and medical reform, anaesthesia workforce and workload, as well as for other medical specialties in China changed dramatically, but the detail information have not been presented. A national off-line survey was designed to learn the current status for anaesthesiology, to analyze the related issues for medicine and to make suggestions for government to improve equity and quality of healthcare in China. Methods: From Mar 1 to Jun 30 in 2015, Chinese Society of Anaesthesiologits (CSA) released questionnaires containing hospital general information, anaesthesia-related information and surgical-related information to all the anaesthesiology departments in mainland China, except Hong Kong, Macao and Taiwan of China. Other relative data sources were searched from publications or website. Results: A total of 16280 questionnaires were released and 14076 copies (86.5% ) were retrieved. There were 13489 copies (82.9%) identified as anaesthesia related data copies (ARDC) and 7026 copies (43.2% ) identified as surgical related data copies (SRDC). In 2014, there were 77926 anaesthesiologists and its density was 5.7 per 100,000 population, 27.66 million inside operating room (OR) anaesthesia cases and 11.47 million outside OR anaesthesia cases were done. GDP per capita in each province was positively correlated with densities of physicians, anaesthesiologists and anaesthesia cases. One attending anaesthesiologist covered 634 inside OR and 263 outside OR anaesthesia cases in 2014. In SRDC, attending surgeons to attending anaesthesiologists ratio was 7.5 to 1. Each attending surgeon had 0.93 operation day per week and performed 86 operations in 2014. Generally, the higher-level and largersized hospitals had higher surgeons to anaesthesiologists ratio, higher surgeons to ORs ratio, less operation day per week for one surgeon, more operations and anesthesia cases done by one surgeon and one anaesthesiologist. Conclusions: China has the biggest number of anaesthesiologists in the world, but is still in shortage of anaesthesiologists. Economic level was positively correlated with anaesthesia workforce and anaesthesia service for all provinces in China. Significant misdistribution and imbalance in different provinces, sized hospitals and medical specialties were found in this survey. A national needs-based resident recruitment system along with the set-up of compulsory standardized resident training system should be taken into consideration and action.

Why is the labor epidural rate low and cesarean delivery rate high? A survey of Chinese perinatal care providers

“…However, it is important to note that among ANs "increasing incentives" was the most popular option. These choices reflect the demographic of physicians In China where there are currently only 5 anesthesiologists per 100,000 people compared to 20 per 100,000 in the US [23][24][25]. Obstetric anesthesiologists playing a vital role in parturient safety [26], however, the specialty does not officially exist in China.…”

Anaesthesiology in China: present and future

“…13 Physician burnout is a worldwide problem, especially for anaesthesiologists; in China, a burnout rate of 69% in residents and 73% in attending anaesthesiologists was reported in 2018. 14 Although there were already 77 926 anaesthesiologists in China in 2014, the density was just 5.7 per 100 000 population, 4 which was much lower than the densities in high-income countries, such as France (14.8), USA (12.7), and UK (11.5). The global ratio of surgeons plus obstetricians to anaesthesiologists was 2.9:1, but China had a much higher ratio of 7.5:1 in 2014.…”

“…In 2014, there were 27.66 million anaesthesia procedures inside the operating room (OR) and 11.47 million outside the OR in the whole country. 4 Anaesthesia has made a great contribution to national healthcare improvement in China.…”

“…In recent years, China has witnessed extensive improvements in anaesthesia care. According to a survey from 167 countries published in 2015, 5 there were 550 134 anaesthesiologists worldwide; China had at least 77 926 anaesthesiologists in 2014 4 and more than 90 025 in 2018. Currently, China maintains the largest number of anaesthesiologists, and the CSA has become one of the largest anaesthesiology societies worldwide.…”

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