Kairys Jonas, Zebiene Egle, Sapoka Virginijus, Zokas Ignas
Department of Social Medicine, Vilnius University, Lithuania.
Cent Eur J Public Health. 2008 Mar;16(1):29-33. doi: 10.21101/cejph.a3444.
Physician satisfaction is considered an important factor influencing quality of health care provision, patient compliance, and costs to health care systems. Dissatisfaction leads to an increase in turnover of physicians and early retirement, which has a negative impact on continuity and quality of health care. Physician dissatisfaction with certain aspects of health care provision may also help to identify potential weaknesses in satisfactory functioning of health care systems. The aim of the current research project is to study the satisfaction with different organizational aspects of health care provision in Lithuania as judged by a selection of physicians.
The study was conducted in Lithuania in June 2004. Physicians in randomly selected health care centers were invited to take part in the survey, 505 primary and secondary care physicians were interviewed by external interviewers during the study period. Physicians were asked to express their satisfaction on items presented in a questionnaire. The questionnaire consisted of 22 questions, evaluating different aspects of health care services - working conditions, workload, financial remuneration, organization of health care infrastructure and availability of laboratory services. Answers were presented by the 5 point Likert type scale, ranging from "very satisfied" (5) to "very dissatisfied" (1).
Physicians who were most satisfied with their working conditions were working in private primary health care practices (91.1% satisfied or very satisfied), as compared with 54% of physicians working in state-owned primary care institutions and 49.7% in hospitals. Physicians working in cities and regional centers or towns were more satisfied with organizational aspects of health care services than physicians working in rural health care centers. Satisfaction with their financial remuneration showed that 74% of respondents stated they were "dissatisfied" or "very dissatisfied". While asked about potential deficiencies in their health care institutions, the most important identified by respondents in all localities was a perceived lack of financial support for these institutions.
There is a significant difference in the perception of physicians in private and state health care institutions with regard to financial remuneration as well as availability of laboratory diagnostic and treatment equipment and working conditions. Based on the study findings, possibilities to increase Primary Care financing should be considered in order to improve the quality of the delivery of health care services as well as retain physicians within the health care system. Results of this study demonstrate a need of further research to quantify what could be reasonably expected from diagnostic and investigative resources to support health care in Lithuania in current economic situation.
医生满意度被视为影响医疗服务质量、患者依从性以及医疗系统成本的重要因素。不满会导致医生离职率上升和提前退休，这对医疗服务的连续性和质量产生负面影响。医生对医疗服务某些方面的不满也可能有助于识别医疗系统良好运作中的潜在弱点。当前研究项目的目的是研究立陶宛部分医生对医疗服务不同组织方面的满意度。
该研究于2004年6月在立陶宛进行。随机选取的医疗中心的医生被邀请参与调查，在研究期间，505名初级和二级医疗医生接受了外部访谈人员的访谈。医生们被要求对问卷中列出的项目表达他们的满意度。问卷由22个问题组成，评估医疗服务的不同方面——工作条件、工作量、经济报酬、医疗基础设施的组织以及实验室服务的可及性。答案采用5级李克特量表呈现，从“非常满意”（5分）到“非常不满意”（1分）。
对工作条件最满意的医生是在私立初级医疗诊所工作的医生（91.1%满意或非常满意），相比之下，在国有初级医疗机构工作的医生中有54%满意，在医院工作的医生中有49.7%满意。在城市、地区中心或城镇工作的医生比在农村医疗中心工作的医生对医疗服务的组织方面更满意。对经济报酬的满意度显示，74%的受访者表示他们“不满意”或“非常不满意”。当被问及他们所在医疗机构的潜在不足时，所有地区的受访者认为最重要的是这些机构缺乏资金支持。
私立和国有医疗机构的医生在经济报酬、实验室诊断和治疗设备的可及性以及工作条件方面的看法存在显著差异。基于研究结果，应考虑增加初级医疗资金的可能性，以提高医疗服务的质量，并在医疗系统内留住医生。本研究结果表明需要进一步研究，以量化在当前经济形势下，立陶宛的诊断和调查资源为支持医疗服务可以合理预期达到的水平。
