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中国西部基层医生的工作满意度。

Job satisfaction among primary care physicians in western China.

机构信息

State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, 999078, Macau, China.

School of Health Services Management, Xi'an Medical University, Xi'an, 710021, Shaanxi, China.

出版信息

BMC Fam Pract. 2020 Oct 25;21(1):219. doi: 10.1186/s12875-020-01292-w.

Abstract

BACKGROUND

There has been great shortage of primary care physicians (PCPs) in China, especially in western areas. Job satisfaction plays a great role in retaining people. The aim of this study is to investigate the job satisfaction of PCPs and associated factors in 11 provinces of western China, thus providing necessary reference values for stabilizing the primary care workforce and improving the quality of primary care services.

METHOD

A sample of 2103 PCPs working in western China were surveyed using a stratified, multistage and random sampling method in 2011. The characteristics of participants were recorded by a structured questionnaire. A multilevel model (MLM) and quantile regression (QR) were applied to assess the association between job satisfaction and possible risk factors.

RESULTS

Of the 2103 doctors surveyed, the overall satisfaction score was 3.26 ± 0.68 (from 1 to 5). MLM indicated that age group, income satisfaction, unit policy approval, personal planning, career attitude, work value and patient recognition were positively correlated with job satisfaction, while turnover intention was negatively correlated with job satisfaction. QR were not completely consistent with MLM and further explored the differences in different job satisfaction score percentiles on each domains.

CONCLUSION

This study showed that the job satisfaction of PCPs in western China was not high. The MLM and QR discussed were not entirely consistent, the latter one provided more information and robust results. Measures should be taken in streamlining administration and institute decentralization, creating more opportunities for additional training, raising PCPs' income, improving the social status of doctors and improving the relationship between doctors and patients.

摘要

背景

中国,尤其是西部地区,基层医疗服务提供者(PCP)严重短缺。工作满意度在人员保留方面起着重要作用。本研究旨在调查中国西部 11 个省份的 PCP 工作满意度及其相关因素,为稳定基层医疗队伍和提高基层医疗服务质量提供必要的参考依据。

方法

2011 年,采用分层、多阶段和随机抽样方法对中国西部的 2103 名 PCP 进行了抽样调查。通过结构化问卷记录参与者的特征。采用多层模型(MLM)和分位数回归(QR)评估工作满意度与可能的风险因素之间的关系。

结果

在所调查的 2103 名医生中,总体满意度评分为 3.26±0.68(1 至 5 分)。MLM 表明,年龄组、收入满意度、单位政策认可、个人规划、职业态度、工作价值观和患者认可与工作满意度呈正相关,而离职意向与工作满意度呈负相关。QR 与 MLM 不完全一致,并进一步探讨了各领域不同工作满意度评分百分位的差异。

结论

本研究表明,中国西部 PCP 的工作满意度不高。讨论的 MLM 和 QR 并不完全一致,后者提供了更多的信息和更稳健的结果。应采取措施简化管理和实行权力下放,为更多的培训机会创造条件,提高 PCP 的收入,提高医生的社会地位,改善医患关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/075a/7586689/103cb4cd2429/12875_2020_1292_Fig1_HTML.jpg

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