J Anesth Perioper Med. 2017;4(2):67-75. https://doi.org/10.24015/ebcmed.japm.2017.0006

Anesthesia Workforce and Workload in China: A National Survey

Lei Yang1*, Tao Zhu1*, Jia-Jin Li2, and Jin Liu1

From 1Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China; 2Medical Insurance Office, West China Hospital, Sichuan University, Chengdu, China.

*Lei Yang and Tao Zhu contributed equally to this work.

Correspondence to Dr. Jin Liu at scujinliu@foxmail.com.

EBCMED ID: ebcmed.japm.2017.0006 DOI: 10.24015/ebcmed.japm.2017.0006


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.

Article Type
Original Article

Declaration of Interests
The authors declared no other competing interests.

Acknowledgements
This study was supported by Beijing Medical and Health Foundation.

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