Bayati Mohsen, Rashidian Arash, Akbari Sari Ali, Emamgholipour Sara
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2017 Jul 27;31:41. doi: 10.14196/mjiri.31.41. eCollection 2017.
Based on the target income hypothesis, the economic behavior of physicians is mainly affected by their target income. This study aimed at designing an instrument to explain how general practitioners (GPs) set their desired income. A self-administered questionnaire of affecting factors on GPs' target income was extracted from literature reviews and a small qualitative study. Respondents were 666 GPs who completed the questionnaire (response rate= 52%) during 2 seasonal congresses of Iranian GPs. The principal component analysis (PCA) with varimax rotation was used to classify the variables and data reduction. Sample adequacy test, sphericity test, eigenvalues of components, and scree plot were evaluated for PCA. Cronbach's alpha was also checked to assess the internal consistency of the principal components. The results of the KMO measure of sampling adequacy (0.657) and Bartlett's test of sphericity (809.05, p<0.001) revealed that the collected data were suitable for PCA. Based on the scree plot pattern and eigenvalues greater than 1, 6 components including perceived comparative income, importance of responsiveness to patients, perceived socioeconomic status, economic expectations, socioeconomic status of paternal family, and provision of luxury services were selected, which explained 65.19% of the total variance. Finally, only those with a Cronbach's alpha value higher than 0.6 were considered reliable (the first 4 components). Based on the target income hypothesis, a physician's desired level of income affects their behavior. Our developed instrument and its mentioned components can be used in future studies related to GPs' behavior, especially those studies related to the economic aspects of GPs' behavior. It also helps formulate a better payment mechanism for primary care providers.
基于目标收入假说，医生的经济行为主要受其目标收入的影响。本研究旨在设计一种工具，以解释全科医生（GP）如何设定其期望收入。通过文献综述和一项小型定性研究，提取了一份关于影响全科医生目标收入因素的自填式问卷。受访者为666名全科医生，他们在伊朗全科医生的两次季节性大会期间完成了问卷（回复率 = 52%）。采用主成分分析（PCA）和方差最大化旋转对变量进行分类和数据降维。对PCA进行了样本充足性检验、球形检验、成分特征值和碎石图评估。还检查了Cronbach's alpha系数，以评估主成分的内部一致性。抽样充足性的KMO度量结果（0.657）和Bartlett球形检验结果（809.05，p<0.001）表明，收集的数据适合进行PCA。根据碎石图模式和大于1的特征值，选择了6个成分，包括感知比较收入、对患者反应性的重要性、感知社会经济地位、经济期望、父系家庭的社会经济地位以及提供豪华服务，这些成分解释了总方差的65.19%。最后，只有Cronbach's alpha值高于0.6的成分才被认为是可靠的（前4个成分）。基于目标收入假说，医生期望的收入水平会影响他们的行为。我们开发的工具及其提及的成分可用于未来与全科医生行为相关的研究，特别是那些与全科医生行为经济方面相关的研究。它也有助于为初级保健提供者制定更好的支付机制。
