Nivel - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands.
Trimbos Institute, Da Costakade 45, 3521VS, Utrecht, The Netherlands.
Hum Resour Health. 2021 Apr 27;19(1):57. doi: 10.1186/s12960-021-00604-0.
Job satisfaction of general practitioners (GPs) is important because of the consequences of low satisfaction for GPs, their patients and the health system, such as higher turnover, health problems for the physicians themselves, less satisfied patients, poor clinical outcomes and suboptimal health care delivery. In this study, we aim to explain differences in the job satisfaction of GPs within and between countries.
We performed a secondary analysis of cross-sectional survey data, collected between 2010 and 2012 on 7379 GPs in 34 (mostly European) countries, as well as data on country and health system characteristics from public databases. Job satisfaction is measured through a composite score of six items about self-reported job experience. Operationalisation of the theoretical constructs includes variables, such as the range of services GPs provide, working hours, employment status, and feedback from colleagues. Data were analysed using linear multilevel regression analysis, with countries and GPs as levels. We developed hypotheses on the basis of the Social Production Function Theory, assuming that GPs 'produce' job satisfaction through stimulating work that provides a certain level of comfort, adds to their social status and provides behavioural confirmation.
Job satisfaction varies between GPs and countries, with high satisfaction in Denmark and Canada (on average 2.97 and 2.77 on a scale from 1-4, respectively) and low job satisfaction in Spain (mean 2.15) and Hungary (mean 2.17). One-third of the total variance is situated on the country level, indicating large differences between countries, and countries with a higher GDP per capita have more satisfied GPs. Health system characteristics are not related to GP job satisfaction. At the GP and practice level, performing technical procedures and providing preventive care, feedback from colleagues, and patient satisfaction are positively related to GP job satisfaction and working more hours is negatively related GP job satisfaction.
Overall and in terms of our theoretical approach, we found that GPs are able to 'produce' work-related well-being through activities and resources related to stimulation, comfort and behavioural confirmation, but not to status.
全科医生（GP）的工作满意度很重要，因为满意度低会对 GP、他们的患者和医疗体系造成一系列后果，例如更高的离职率、医生自身的健康问题、对患者满意度降低、临床结果不佳和医疗服务提供不理想等。在这项研究中，我们旨在解释国家内部和国家之间 GP 工作满意度的差异。
我们对 2010 年至 2012 年间在 34 个（主要是欧洲）国家的 7379 名全科医生进行的横断面调查数据进行了二次分析，以及来自公共数据库的国家和医疗体系特征数据。工作满意度通过关于自我报告工作经验的六个项目的综合评分来衡量。理论结构的操作化包括 GP 提供的服务范围、工作时间、就业状况以及同事的反馈等变量。使用线性多层回归分析，以国家和 GP 为层次进行数据分析。我们根据社会生产函数理论提出了假设，假设 GP 通过提供一定舒适度、增加社会地位和提供行为确认的刺激性工作来“产生”工作满意度。
GP 和国家之间的工作满意度存在差异，丹麦和加拿大的满意度较高（平均分别为 2.97 和 2.77，分值范围为 1-4），西班牙（平均 2.15）和匈牙利（平均 2.17）的满意度较低。总方差的三分之一位于国家层面，表明国家之间存在很大差异，人均 GDP 较高的国家 GP 的满意度也较高。医疗体系特征与 GP 工作满意度无关。在 GP 和实践层面，执行技术程序和提供预防保健、同事的反馈以及患者满意度与 GP 工作满意度呈正相关，工作时间更长与 GP 工作满意度呈负相关。
总体而言，根据我们的理论方法，我们发现 GP 能够通过与刺激、舒适和行为确认相关的活动和资源来“产生”与工作相关的幸福感，但无法通过地位来实现。
