Zhang Qi, Chen Jiayan, Yang Min, Pan Jay, Li Xiaoping, Yue Lin, Huang Yuan, Mao Tao, Zhang Cong, Ma Xiao
West China School of Public Health, Sichuan University, Chengdu, Sichuan.
School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei.
Medicine (Baltimore). 2019 Aug;98(32):e16693. doi: 10.1097/MD.0000000000016693.
To strengthen rural health services, the Chinese government has launched a series of policies to promote health workforce development. This study aims to understand the current status of village doctors and to explore the factors associated with village doctors' job satisfaction in western China. It also attempts to provide references for further building capacities of village doctors and promoting the development of rural health service policy.A multistage stratified sampling method was used to obtain data from a cross-sectional survey on village doctors across 2 provinces of western China during 2012 to 2013. Quantitative data were collected from village doctors face-to-face, through a self-administered questionnaire.Among the 370 respondents, 225 (60.8%) aged 25 to 44 years, and 268 (72.4%) were covered by health insurance. Their income and working time calculated by workloads were higher than their self-report results. Being healthy, working fewer years, and having government funding and facilities were the positive factors toward their job satisfaction. Village doctors working with government-funded village clinics or facilities were more likely to feel satisfied.Problems identified previously such as low income and lack of insurance, heavy workload and aging were not detected in our study. Instead, village doctors were better-paid and better-covered by social insurance than other local rural residents, with increased job satisfaction. Government policies should pay more attention to improving the quality of rural health services and the income and security system of village doctors, to maintain and increase their job satisfaction and work enthusiasm. Further experimental study could evaluate effects of government input to improve rural health human resources and system development.
为加强农村医疗卫生服务，中国政府出台了一系列政策以促进卫生人力发展。本研究旨在了解乡村医生的现状，并探讨中国西部乡村医生工作满意度的相关因素。同时，本研究还试图为进一步提升乡村医生能力以及推动农村医疗卫生服务政策发展提供参考。
采用多阶段分层抽样方法，从2012年至2013年中国西部2个省份乡村医生的横断面调查中获取数据。通过自填式问卷，与乡村医生进行面对面交流，收集定量数据。
在370名受访者中，225名（60.8%）年龄在25至44岁之间，268名（72.4%）参加了医疗保险。按工作量计算，他们的收入和工作时间高于其自我报告结果。身体健康、工作年限较短、有政府资金和设施是影响其工作满意度的积极因素。在政府资助的村卫生室或设施工作的乡村医生更易感到满意。
本研究未发现之前提到的诸如收入低、缺乏保险、工作量大以及老龄化等问题。相反，乡村医生的收入高于当地其他农村居民，社会保险覆盖情况更好，工作满意度有所提高。政府政策应更加注重提高农村医疗卫生服务质量以及乡村医生的收入和保障体系，以维持并提升他们的工作满意度和工作积极性。进一步的实验研究可评估政府投入对改善农村卫生人力资源和体系发展的效果。
