García-Peña C, Reyes-Frausto S, Reyes-Lagunes I, Muñoz-Hernández O
Department of Epidemiological and Health Services Research and Medical Research Coordination, Mexican Institute of Social Security (IMSS) and Psychology Faculty, National University of Mexico.
Fam Pract. 2000 Aug;17(4):309-13. doi: 10.1093/fampra/17.4.309.
The aim of the present study was to estimate physician job satisfaction at the Mexican Institute of Social Security (IMSS), the Ministry of Health (SSA) and in the private sector, and to measure the association between these different family medical care organization models.
A comparative cross-sectional design was used to investigate the job satisfaction of family physicians in private and institutional family medicine clinics. Satisfaction was measured with a previously constructed and validated instrument. The instrument measures the satisfaction in four areas: 'global satisfaction', 'institution where the physician works', 'the patients' and 'themselves as physicians'.
One hundred and seven IMSS physicians, 106 SSA physicians and 97 private physicians were selected randomly from a census according to the sample size. The sample was weighted. Fifty-one percent of IMSS and SSA physicians were dissatisfied, against 25% in the private sector, in the first three areas. Comparing the private model and the IMSS, differences were found (P < 0.0001) in the area of 'global satisfaction' [odds ratio (OR) = 2.47, 95% confidence interval (CI) 1.69-3.67], 'institution where the physician works' (OR = 2.12, CI 1. 45-3.13) and 'themselves as physicians' (OR = 1.84, CI 1.28-2.65). When the private/SSA groups were compared, the differences were similar (P < 0.0001). No differences were found in terms of 'the patients'. When stratifying, the risks increased in females, in the group aged 31-40 years and in specialists in family medicine.
The organization model is associated with dissatisfaction in all areas, except in 'the patients'.
本研究旨在评估墨西哥社会保障局（IMSS）、卫生部（SSA）以及私营部门的医生工作满意度，并衡量这些不同家庭医疗护理组织模式之间的关联。
采用比较横断面设计来调查私立和机构性家庭医学诊所中家庭医生的工作满意度。使用先前构建并验证的工具来衡量满意度。该工具在四个领域衡量满意度：“总体满意度”、“医生工作的机构”、“患者”以及“作为医生的自身”。
根据样本量从普查中随机选取了107名IMSS医生、106名SSA医生和97名私立医生。样本进行了加权处理。在前三个领域，51%的IMSS和SSA医生表示不满，而私营部门为25%。比较私营模式和IMSS，在“总体满意度”领域发现差异（P < 0.0001）[优势比（OR）= 2.47，95%置信区间（CI）1.69 - 3.67]，“医生工作的机构”（OR = 2.12，CI 1.45 - 3.13）以及“作为医生的自身”（OR = 1.84，CI 1.28 - 2.65）。当比较私营/SSA组时，差异相似（P < 0.0001）。在“患者”方面未发现差异。分层分析时，女性、31 - 40岁年龄组以及家庭医学专科医生的风险增加。
组织模式与除“患者”外的所有领域的不满相关。
