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根据医生的执业模式比较全科医生:多专业团队实践是否与更有利的工作条件相关?

Comparing GPs according to their model of practice: are multiprofessional group practices associated with more favourable working conditions?

机构信息

CESP, Inserm UMR 1018, Team Primary Care and Prevention, 16, Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France.

Institute for Research and Information in Health Economics (IRDES), 21 - 23 rue des Ardennes, 75019, Paris, France.

出版信息

Eur J Health Econ. 2024 Dec;25(9):1625-1640. doi: 10.1007/s10198-024-01687-x. Epub 2024 Apr 3.

Abstract

In the generalized context of general practitioner shortages and transitions towards team-based primary care, we investigated how the different practising models relate to general practitioners' labour supply. More precisely, we analysed the association between practice models-solo, groups of general practitioners, and multiprofessional groups-and their reported labour supply and level of satisfaction with work-life balance. We used a French cross-sectional survey from 2018 that surveyed a representative national sample of 3,032 self-employed general practitioners about their working conditions. We found that the model of practice was significantly associated with differences in physician labour supply at the intensive margin and that group practice appeared to be positively associated with general practitioners' reported satisfaction with work-life balance. In terms of weekly working time, only practice in groups of general practitioners was associated with a significantly lower labour supply. However, general practitioners in groups-whether groups of general practitioners or multiprofessional groups-reported more annual leave and seemed more willing to diversify their activity by devoting more time to secondary activities, including salaried activities. Consistently, general practitioners working in groups were also more likely than solo practitioners to report being satisfied with their work-life balance. Although group practice, whether multiprofessionnal or not, seems to be well suited to meeting the new aspirations of general practitioners, those working in multiprofessional groups are associated with a higher level of weekly work supply, which might justify special attention from the public authorities.

摘要

在全科医生短缺和向团队为基础的初级保健转变的普遍背景下,我们研究了不同的执业模式与全科医生劳动力供应之间的关系。更确切地说,我们分析了实践模式(单人执业、全科医生小组和多专业小组)与其报告的劳动力供应和工作生活平衡满意度之间的关系。我们使用了 2018 年的一项法国横断面调查,该调查对全国范围内有代表性的 3032 名自营全科医生的工作条件进行了调查。我们发现,执业模式与医生劳动力供应的差异在密集边际上显著相关,小组执业似乎与全科医生对工作生活平衡的满意度呈正相关。就每周工作时间而言,只有全科医生小组执业与劳动力供应显著下降有关。然而,无论是全科医生小组还是多专业小组,小组执业的全科医生报告的年假更多,似乎更愿意通过从事更多的第二职业活动,包括带薪活动来使他们的活动多样化。一致的是,小组执业的全科医生也比单人执业的全科医生更有可能对他们的工作生活平衡感到满意。尽管小组执业(无论是多专业的还是非多专业的)似乎非常适合满足全科医生的新愿望,但在多专业小组工作的全科医生与更高的每周工作供应相关,这可能需要公共当局给予特别关注。

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