Human Resources in Primary Health-Care Institutions before and after the New Health-Care Reform in China from 2003 to 2019: An Interrupted Time Series Analysis

At the end of March 2009, the Chinese government put forward the new health-care reform with its long-term goal to achieve universal access to basic medical and health services. Primary health-care institutions and adequate health human resources are the basic and specific guarantee to achieve the above goals. We aimed to explore the differences in the trends of human resources before and after the new health-care reform from 2003 to 2019, based on Chinese Health Statistics Yearbook, an using interrupted time series analysis. The number of primary health workers serving for every 1000 people in China gradually rose from 1.98 in 2003 to 3.07 in 2020, with an immediate sharp rise from 2008 to 2009. Subsequently, the number of primary health workers increased at a significant speed, but it still failed to meet people’s basic medical needs (3.5/1000). There was an increase of 51,301 primary health staff in 2010, and 6007 more primary health workers per year were added after the reform compared to the basic increasing number before 2009, but both were not statistically significant (p > 0.05). The annual increased number of health workers in township health centers was 2.63 times greater than that before the reform, with a total annual increase of 34,192 people (p < 0.05). The growth trend changed the most in western China (p < 0.001), while the human resources of primary health-care institutions in the eastern region were relatively richer than those in the central and western regions. Numerous registered nurses and pharmacists have been devoted to the construction of the primary health-care service since 2010, while the increase in the number of doctors per year was not statistically significant (p = 0.066). In total, the primary health-care human resource in China is constantly expanding, but the primary health-care needs are still not fully met, especially for doctors, and the problem of unbalanced allocation urgently needs to be solved. Reasonably formulating regional policies to strengthen the construction of primary health personnel and expand the accessibility of primary health services is the top priority in the development of primary medical and health undertakings.