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日本医院雇佣医生的工作满意度与医疗质量

Physician job satisfaction and quality of care among hospital employed physicians in Japan.

作者信息

Utsugi-Ozaki Makiko, Bito Seiji, Matsumura Shinji, Hayashino Yasuaki, Fukuhara Shunichi

机构信息

Department of Epidemiology and Healthcare Research, Graduate School of Public Health and Medicine, Kyoto University, Kyoto, Japan.

出版信息

J Gen Intern Med. 2009 Mar;24(3):387-92. doi: 10.1007/s11606-008-0886-4. Epub 2009 Jan 6.

Abstract

BACKGROUND

Physician job satisfaction is reportedly associated with interpersonal quality of care, such as patient satisfaction, but its association with technical quality of care, as determined by whether patients are offered recommended services, is unknown.

OBJECTIVE

We explored whether the job satisfaction of hospital-employed physicians in Japan is associated with the technical quality of care, with an emphasis on process qualities as measured by quality indicators.

DESIGN

Cross-sectional study linking data from physician surveys with data abstracted from outpatient charts.

PARTICIPANTS

A total of 53 physicians working at 13 hospitals in Japan participated. Medical records covering 568 patients were reviewed.

MEASUREMENTS

Disease-specific indicators related to the care of patients with hypertension, type 2 diabetes, and asthma, as well as disease-independent measures of the process of care were abstracted. We analyzed the association between the quality of care score for individual physicians, which is defined as the percentage of quality indicators satisfied among the total for which their patients were eligible, and physician job satisfaction, which was measured by a validated scale.

RESULTS

No statistically significant association between physician job satisfaction and quality of care was observed. A 1-standard deviation (SD) increment in the physician job satisfaction scale was associated with an increase of only 0.3% for overall quality (P = 0.85), -3.0% for hypertension (P = 0.22), 2.5% for type 2 diabetes (P = 0.44), 8.0% for asthma (P = 0.21), and -0.4% for cross-cutting care (P = 0.76).

CONCLUSION

Contrary to the positive association reported between physician job satisfaction and high quality of interpersonal care, no association was seen between physician job satisfaction and the technical quality of care.

摘要

背景

据报道,医生工作满意度与人际医疗质量相关,如患者满意度,但它与由是否为患者提供推荐服务所决定的技术医疗质量之间的关联尚不清楚。

目的

我们探讨了日本医院聘用医生的工作满意度是否与技术医疗质量相关,重点关注通过质量指标衡量的过程质量。

设计

将医生调查数据与门诊病历摘要数据相联系的横断面研究。

参与者

日本13家医院的53名医生参与。审查了涵盖568名患者的病历。

测量

提取了与高血压、2型糖尿病和哮喘患者护理相关的疾病特异性指标,以及护理过程的非疾病特异性指标。我们分析了个体医生的医疗质量得分(定义为其患者符合条件的质量指标总数中得到满足的百分比)与通过有效量表测量的医生工作满意度之间的关联。

结果

未观察到医生工作满意度与医疗质量之间存在统计学上的显著关联。医生工作满意度量表增加1个标准差,总体质量仅增加0.3%(P = 0.85),高血压增加 -3.0%(P = 0.22),2型糖尿病增加2.5%(P = 0.44),哮喘增加8.0%(P = 0.21),跨领域护理增加 -0.4%(P = 0.76)。

结论

与报道的医生工作满意度与高质量人际医疗之间的正相关相反,未发现医生工作满意度与技术医疗质量之间存在关联。

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