Kato Ken, Yamauchi Kazunobu, Miyaji Makoto, Fujiwara Nakako, Katsuyama Kimiko, Amano Hiroshi, Kobayashi Santaro, Naito Michio, Maki Yasunori, Kawahara Hirohisa, Maseki Mitsuaki, Senoo Yoshio
Department of Medical Information and Management Science, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Int J Health Care Qual Assur. 2012;25(1):19-40. doi: 10.1108/09526861211192386.
This study seeks to investigate doctors' desire to change the hospital where they work to sustain higher quality care.
DESIGN/METHODOLOGY/APPROACH: Self-administered questionnaires were sent to doctors in Aichi Prefecture, Japan. Data were analyzed using univariate and logistic regression analysis and recursive partitioning.
Factors related to doctors' desire to change hospitals, according to logistic regression, were interaction between working hours and satisfaction with the hospital, evaluation, local government hospitals versus private ones, small vs large hospitals, ophthalmology versus internal medicine, desire to continue working as a hospital doctor and age. Additionally, working hours were also found to be related, based on recursive partitioning.
RESEARCH LIMITATIONS/IMPLICATIONS: The response rate was low and sampling bias was observed--therefore results need careful interpretation. Also, because this was a cross-sectional study, causal relationships could not be identified. Desire to change hospitals, but not actual behavior, was measured.
Efforts to prevent doctors from changing hospitals should include considering job satisfaction and workload, doctor evaluation methods, support for career progression and organizational management.
ORIGINALITY/VALUE: As the hospital doctor shortage in rural areas becomes more serious, exploring doctors' desire to leave their current hospital is meaningful for Japanese hospital managers and hospitals worldwide aiming to provide sustainable and higher quality care.
本研究旨在调查医生更换工作医院以维持更高质量医疗服务的意愿。
设计/方法/途径:向日本爱知县的医生发放了自填式问卷。使用单变量和逻辑回归分析以及递归划分对数据进行了分析。
根据逻辑回归分析,与医生更换医院意愿相关的因素包括工作时长与对医院满意度之间的相互作用、评价、地方政府医院与私立医院、小型医院与大型医院、眼科与内科、继续担任医院医生的意愿以及年龄。此外,基于递归划分还发现工作时长也与之相关。
研究局限性/启示:回复率较低且存在抽样偏差,因此结果需要谨慎解读。此外,由于这是一项横断面研究,无法确定因果关系。测量的是更换医院的意愿而非实际行为。
防止医生更换医院的努力应包括考虑工作满意度和工作量、医生评价方法、职业发展支持以及组织管理。
原创性/价值:随着农村地区医院医生短缺问题日益严重,探索医生离开当前医院的意愿对于日本医院管理者以及全球致力于提供可持续和更高质量医疗服务的医院具有重要意义。