STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Health Publicity and Education Center of Guangdong Province, Guangzhou, Guangdong, China.
BMJ Open. 2024 Nov 17;14(11):e084859. doi: 10.1136/bmjopen-2024-084859.
Primary health workers are crucial to the healthcare system, yet China experiences a notable shortage driven by high turnover rates. This study aimed to investigate the prevalence and determinants of turnover intention among primary health workers.
Cross-sectional study.
Primary healthcare facilities across 21 cities in Guangdong province, China.
Online questionnaires (SurveyStar, Changsha Ranxing Science and Technology) were administered to 16 573 primary health workers in September and October 2022.
Variables measured included demographics, work-related factors, job satisfaction, emotional exhaustion and turnover intention. Comparisons of turnover intention were made across different categorical groups, and hierarchical regression analysis was used to pinpoint influencing factors.
The average turnover intention score among participants was 10.49±2.93. Notable positive correlations included those with male gender, single marital status, leadership positions and roles as public health physicians. Emotional exhaustion correlated positively (β=0.108), while job satisfaction showed a significant negative correlation (β=-0.154). Other negative influential factors were observed with tenure lengths of 6-10 years, 11-15 years and ≥16 years, as well as with senior professional titles, lower salary levels and perceptions of fair compensation.
Turnover intention is notably prevalent among primary healthcare workers, with emotional exhaustion and job satisfaction identified as primary determinants. Salary, payment justice in compensation and tenure also significantly influence turnover intention. Based on the above analysis, a series of intervention measures can be expectedly unveiled to reduce the turnover intention of primary health workers and maintained the steady development of basic medical resources.
基层卫生工作者是医疗体系的重要组成部分，但由于高离职率，中国基层卫生工作者严重短缺。本研究旨在调查基层卫生工作者离职意愿的流行率及其决定因素。
横断面研究。
中国广东省 21 个城市的基层医疗保健机构。
2022 年 9 月至 10 月，通过在线问卷（SurveyStar，长沙然星科技）对 16573 名基层卫生工作者进行调查。
测量的变量包括人口统计学、工作相关因素、工作满意度、情绪耗竭和离职意愿。对不同分类组的离职意愿进行了比较，并使用分层回归分析确定了影响因素。
参与者的平均离职意愿得分为 10.49±2.93。具有显著正相关的因素包括男性、单身、领导职位和公共卫生医师角色。情绪耗竭呈正相关（β=0.108），而工作满意度呈显著负相关（β=-0.154）。其他负向影响因素包括工作年限 6-10 年、11-15 年和≥16 年，以及高级专业职称、较低的薪酬水平和公平薪酬的认知。
基层医疗卫生工作者的离职意愿显著，情绪耗竭和工作满意度是主要决定因素。薪酬、薪酬公平性和工作年限也显著影响离职意愿。基于以上分析，可以预期会采取一系列干预措施，以降低基层卫生工作者的离职意愿，维持基本医疗资源的稳定发展。
