Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Management Science and Engineering, School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China.
J Glob Health. 2022 Feb 5;12:04005. doi: 10.7189/jogh.12.04005. eCollection 2022.
High turnover among physicians in emergency department is a great challenge in China. However, the rate and the reasons why physicians intend to leave have not been extensively studied yet. Therefore, this study aimed to identify the risk factors of turnover intention among physicians in emergency department.
A national cross-sectional survey was conducted from July to August 2018 in China. A total of 10 457 physicians in emergency department were investigated using a structured self-administered questionnaire, which included demographic characteristics, work-related factors, turnover intention, the Patient Health Questionnaire and Positive and Negative Affect Scale. The stepwise logistic regression analysis was applied to identify the risk factors of turnover intention among physicians.
A total of 55.18% of the physicians in emergency department reported turnover intention in China. Turnover intention were more likely to be reported among physicians who were male (odds ratio (OR) = 1.25, 95% confidence interval (CI) = 1.13-1.38); who perceived medical errors (OR = 1.35, 95% CI = 1.23-1.47); who had a lower average monthly income; who provided out-of-hospital resuscitation services; who experienced physical violence (OR = 1.39, 95% CI = 1.26-1.54) and who reported higher score on negative affect and depressive tendency (OR = 1.06, 95% CI = 1.05-1.08; OR = 1.10, 95% CI = 1.09-1.12). Conversely, physicians who perceived shortage of manpower (OR = 0.74, 95% CI = 0.66-0.81), or reported higher score on positive affect (OR = 0.96, 95% CI = 0.94-0.97) were inclined to stay in emergency department.
This study shows that turnover intention among physicians in emergency department is high in China and was significantly associated with gender, average monthly income, perceived shortage of physicians, the times for provide out-of-hospital resuscitation services, exposure to workplace violence, depressive tendency, positive affect and negative affect. Targeted interventions are required to improve the retention rate among physicians in emergency department from the comprehensive aspects.
医生在急诊科的高离职率是中国面临的一大挑战。然而，医生离职的比例和原因尚未得到广泛研究。因此，本研究旨在确定急诊科医生离职意向的危险因素。
2018 年 7 月至 8 月，在中国进行了一项全国性的横断面调查。共调查了 10457 名急诊科医生，使用结构化的自我管理问卷，包括人口统计学特征、工作相关因素、离职意向、患者健康问卷和正负情感量表。采用逐步逻辑回归分析确定急诊科医生离职意向的危险因素。
中国急诊科医生中有 55.18%报告了离职意向。男性（比值比（OR）=1.25，95%置信区间（CI）=1.13-1.38）、认为发生医疗差错（OR=1.35，95%CI=1.23-1.47）、平均月收入较低、提供院外复苏服务、经历过身体暴力（OR=1.39，95%CI=1.26-1.54）和报告较高的负性情感和抑郁倾向得分（OR=1.06，95%CI=1.05-1.08；OR=1.10，95%CI=1.09-1.12）的医生更有可能报告离职意向。相反，认为人手短缺（OR=0.74，95%CI=0.66-0.81）或报告较高的正性情感得分（OR=0.96，95%CI=0.94-0.97）的医生更倾向于留在急诊科。
本研究表明，中国急诊科医生的离职意向较高，且与性别、平均月收入、认为医生人手短缺、提供院外复苏服务的次数、暴露于工作场所暴力、抑郁倾向、正性情感和负性情感显著相关。需要从综合方面采取有针对性的干预措施，以提高急诊科医生的留任率。
