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私立还是公立?挪威医学专家工作价值观对工作部门选择重要性的实证分析。

Private or public? An empirical analysis of the importance of work values for work sector choice among Norwegian medical specialists.

作者信息

Midttun Linda

机构信息

SINTEF Health Services Research, Department of Health Management and Health Economics, University of Oslo, Norway.

出版信息

Soc Sci Med. 2007 Mar;64(6):1265-77. doi: 10.1016/j.socscimed.2006.11.003. Epub 2006 Dec 11.

Abstract

In the aftermath of the Norwegian hospital reform of 2002, the private supply of specialized healthcare has increased substantially. This article analyses the likelihood of medical specialists working in the private sector. Sector choice is operationalized in two ways: first, as the likelihood of medical specialists working in the private sector at all (at least 1% of the total work hours), and second, as the likelihood of working full-time (90-100%) privately. The theoretical framework is embedded in work values theory and the results suggest that work values are important predictors of sector choice. All analyses are based on a postal questionnaire survey of medical specialists working in private contract practices and for-profit hospitals and a control group of specialists selected from the Norwegian Medical Association's member register. The analyses revealed that while autonomy values impact positively on the propensity for allocating any time at all to the private sector, professional values have a negative effect. Given that the medical specialist already works in the private sector, a high valuation of professional values and payment and benefit values increases the likelihood of having a dual sector job rather than a full-time private position. However, due to the cross-sectional structure of the data and limitations in the dataset, causality questions cannot be fully settled on the basis of the analyses. The relationship between work values and sector choice should, therefore, be regarded as associations rather than causality links. Finally, the likelihood of working in the private sector varies significantly at the municipality level, suggesting that medical specialist's location is important for sector choice.

摘要

在2002年挪威医院改革之后,私立专业医疗服务的供给大幅增加。本文分析了医学专家在私营部门工作的可能性。部门选择通过两种方式来操作化:第一,作为医学专家在私营部门工作的可能性(至少占总工作时间的1%),第二,作为全职(90 - 100%)在私营部门工作的可能性。理论框架基于工作价值观理论,结果表明工作价值观是部门选择的重要预测因素。所有分析均基于对在私立合同诊所和营利性医院工作的医学专家以及从挪威医学协会成员登记册中选取的专家对照组进行的邮政问卷调查。分析显示,虽然自主性价值观对将任何时间分配到私营部门的倾向有积极影响,但专业价值观则有负面影响。鉴于医学专家已经在私营部门工作,对专业价值观以及薪酬和福利价值观的高度重视会增加拥有双部门工作而非全职私营职位的可能性。然而,由于数据的横截面结构和数据集中的局限性,因果关系问题无法在分析的基础上完全解决。因此,工作价值观与部门选择之间的关系应被视为关联而非因果联系。最后,在私营部门工作的可能性在市政层面存在显著差异,这表明医学专家的工作地点对部门选择很重要。

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