School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.
Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.
Hum Resour Health. 2018 Feb 13;16(1):10. doi: 10.1186/s12960-018-0274-z.
The intention to leave a job, known as turnover intention, among primary care doctors has a significant impact on primary health care service delivery. We investigated primary care doctors' turnover intention and analysed associated factors involved in primary health facilities in Chongqing, China.
A total of 440 doctors were interviewed, they were selected using a multi-stage stratified random sampling method. The survey instrument was a self-administered questionnaire which assessed socio-demographic and work-related characteristics, job satisfaction and turnover intention. The data were analysed using χ test, one-way analysis of variance, exploratory factor analysis and linear regression analysis.
Our study found that 42.3% of the primary care doctors we sampled in Chongqing, China, intended to resign. Location, age, job title, doctor's position level, work pressure and job satisfaction were associated with turnover intention. Job satisfaction included both employment-related job satisfaction (including "your chance of promotion", "your rate of pay" and two other items) and satisfaction with the job itself (including "the freedom to choose your own method of working", "your job safety" and two other items).
Improving job satisfaction, in terms of salary, promotion and job safety, is crucial for reducing turnover intention among primary care doctors. Therefore, we suggest that the government increase its financial investment in primary care facilities, especially in less-developed areas, and reform incentive mechanisms to improve the job satisfaction of primary care doctors. The government should consider policies such as establishing a social pension programme for village-level doctors and providing more opportunities for job promotion among primary care doctors, especially township-level doctors. Attention should also be paid to the impact of rapid urbanization, which could lead to increased workload or increased opportunities for career development, thus affecting primary care doctors' turnover intention.
离职意向，即医生离开工作岗位的意愿，对基层医疗服务的提供有重大影响。我们调查了中国重庆市基层医疗机构中基层医生的离职意向，并分析了其中涉及的相关因素。
采用多阶段分层随机抽样方法，对 440 名医生进行访谈。调查工具是一份自填式问卷，评估了社会人口学和工作相关特征、工作满意度和离职意向。使用 χ²检验、单因素方差分析、探索性因子分析和线性回归分析来分析数据。
我们的研究发现，在中国重庆，我们抽样的基层医生中有 42.3%打算辞职。地点、年龄、职称、医生岗位级别、工作压力和工作满意度与离职意向相关。工作满意度既包括与就业相关的工作满意度（包括“晋升机会”、“薪酬”和另外两项），也包括对工作本身的满意度（包括“自由选择工作方法”、“工作安全”和另外两项）。
提高基层医生的薪酬、晋升和工作安全等方面的工作满意度对于降低其离职意向至关重要。因此，我们建议政府增加对基层医疗机构的财政投入，特别是在欠发达地区，并改革激励机制，提高基层医生的工作满意度。政府应考虑制定村级医生社会养老金计划等政策，为基层医生，特别是乡镇级医生提供更多的晋升机会。还应关注快速城市化的影响，这可能导致工作量增加或职业发展机会增加，从而影响基层医生的离职意向。
