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基层公共卫生服务人才队伍建设的优化路径:淮海经济区的一项大规模调查。

Optimization path of primary public health service talent team construction: a largescale survey in Huaihai Economic Zone, China.

机构信息

School of Management, Xuzhou Medical University, Xuzhou, China.

Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

出版信息

Front Public Health. 2024 Aug 21;12:1399857. doi: 10.3389/fpubh.2024.1399857. eCollection 2024.

Abstract

BACKGROUND

The primary public health service system is indispensable for the implementation of the "Healthy China 2030" strategy, and primary healthcare workers, as the key drivers of this system, play a pivotal role in its development and establishment to ensure population well-being. In developing countries, such as China, primary public health systems are still weak, and in order to address this phenomenon, health system reform is needed, and primary public health personnel are crucial to health system reform. The current situation of primary public health workers in low-income and developing countries is characterized by varying degrees of problems that need improvement.

OBJECTIVES

The purpose of this study is to understand the current situation of primary public health service workforce building, analyze the existing problems of the workforce, put forward suggestions for improvement and explore countermeasures, and provide Chinese wisdom and a reference basis for primary public health workforce building in the world, especially in developing countries.

METHODS

Combining the Work-Family Conflict Scale, Copenhagen Burnout Inventory, Minnesota Satisfaction Questionnaire, and Turnover Intention Scale, a relevant survey questionnaire was designed to quantitatively investigate the baseline characteristics of primary public health service institutions and their staff in four representative cities in the Huaihai Economic Zone: Xuzhou in Jiangsu Province, Linyi in Shandong Province, Shangqiu in Henan Province, and Huaibei in Anhui Province. The collected data were analyzed and processed using SPSS 25.0 statistical analysis software through univariate analysis and logistic regression analyses. Methods such as one-way ANOVA, Logistic regression analysis, and independent samples -test were used to analyze the influencing factors of primary public health workforce development.

RESULTS

The current work intensity at the primary public health level is currently high, the salary and benefits cannot meet the needs of most primary public health personnel, and the competition between work and family in terms of time and resources is pronounced, and the majority of primary public health personnel are dissatisfied with the status quo of "doing more work for less reward" and the poor social security. Emotional exhaustion, depersonalization, and a sense of personal accomplishment were positively correlated with the tendency to leave (all  < 0.01), and the burnout and emotional exhaustion of primary public health workers were intense.

CONCLUSION

Primary public health personnel play an important role in providing primary public health services. However, the current working conditions of junior public health personnel in the Huaihai Economic Zone are influenced by factors such as workload, income level, and employment situation improvement, leading to low job satisfaction, significant work-family conflicts, and high turnover intention. In this context, based on the opinions of grassroots administrative departments and internationally relevant experiences, a series of suggestions have been proposed to improve the professional service level, job satisfaction, and occupational identity of staff members. These suggestions make valuable contributions to both the Huaihai Economic Zone and countries worldwide in safeguarding individual health and promoting national primary healthcare reform.

摘要

背景

基层公共卫生服务体系是实施“健康中国 2030”战略不可或缺的,基层卫生工作者作为该体系的主要推动者,在其发展和建立中起着关键作用,以确保人民的健康福祉。在发展中国家,如中国,基层公共卫生体系仍然薄弱,为了解决这一现象,需要进行卫生系统改革,而基层公共卫生人员是卫生系统改革的关键。目前,低收入和发展中国家的基层公共卫生工作者的现状存在不同程度需要改进的问题。

目的

本研究旨在了解基层公共卫生服务队伍建设的现状,分析队伍建设中存在的问题,提出改进建议和探索对策,为世界,特别是发展中国家的基层公共卫生队伍建设提供中国智慧和参考依据。

方法

结合工作家庭冲突量表、哥本哈根倦怠量表、明尼苏达满意度问卷和离职意愿量表,设计了一份与淮海经济区四个有代表性城市(江苏省徐州市、山东省临沂市、河南省商丘市、安徽省淮北市)基层公共卫生服务机构及其工作人员相关的调查问卷,对其进行了定量调查。使用 SPSS 25.0 统计分析软件对收集的数据进行了单因素分析和逻辑回归分析。采用单因素方差分析、逻辑回归分析、独立样本 t 检验等方法分析了基层公共卫生队伍发展的影响因素。

结果

目前基层公共卫生工作强度高,工资福利不能满足大多数基层公共卫生人员的需求,工作与家庭在时间和资源上的竞争明显,大部分基层公共卫生人员对“多劳少得”的现状和较差的社会保障不满意。情绪衰竭、去人格化和个人成就感与离职意愿呈正相关(均<0.01),基层公共卫生工作者的倦怠和情绪衰竭较为严重。

结论

基层公共卫生人员在提供基层公共卫生服务方面发挥着重要作用。然而,淮海经济区初级公共卫生人员的工作现状受到工作负荷、收入水平和就业情况改善等因素的影响,导致工作满意度低、工作家庭冲突明显和离职意愿高。在这种情况下,基于基层行政部门的意见和国际相关经验,提出了一系列提高员工专业服务水平、工作满意度和职业认同的建议。这些建议为淮海经济区乃至世界各国维护个人健康、促进国家初级医疗保健改革做出了有价值的贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60b2/11371681/51bf53c35cf0/fpubh-12-1399857-g001.jpg

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