Zhai Ziyan, Cui Chengsen, Meng Kai
School of Public Health, Capital Medical University, No. 10, Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 10069, China.
China Center for Health Development Studies, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, China.
BMC Prim Care. 2025 May 16;26(1):170. doi: 10.1186/s12875-025-02859-1.
The high turnover intentions among family doctos (FDs) in China have impacted the stability of teams and the quality of healthcare services in community health centers (CHCs). The factors influencing FDs' turnover intentions include not only individual characteristics but also organizational environmental factors within CHCs. This study aims to explore the mechanism of the impact of FDs' professional identification and organizational incentives on their turnover intentions.
This study selected 3 397 FDs from 102 CHCs in six districts of Beijing as the research subjects. Multiple scales were used to quantify FDs' professional identity, turnover intention, and organizational incentives. A Hierarchical Linear Model (HLM) was employed to investigate the effects of organizational-level and individual-level factors on turnover intentions and to analyze the interaction between individuals and organizations.
The study found that FDs' professional identification has a significant negative impact on turnover intentions (Beta=-0.242, P < 0.001). The level of organizational incentives in CHCs had a significant negative impact on turnover intentions (Beta=-0.173, P < 0.001), and the level of organizational incentives played a significant negative moderating role in the process of individual professional identification influencing turnover intentions (Beta = 0.004, P < 0.05).
Enhancing FDs' professional identity can lower their turnover intention, and the impact of personal identity on turnover intention diminishes in institutions with strong organizational incentives. During the training stage of FDs, it is essential to foster a strong personal professional identity value the role of organizational incentives, and optimize the overall organizational environment.
中国家庭医生的高离职意愿影响了社区卫生服务中心团队的稳定性和医疗服务质量。影响家庭医生离职意愿的因素不仅包括个人特征，还包括社区卫生服务中心内部的组织环境因素。本研究旨在探讨家庭医生的职业认同和组织激励对其离职意愿的影响机制。
本研究选取北京市六个区102家社区卫生服务中心的3397名家庭医生作为研究对象。采用多个量表对家庭医生的职业认同、离职意愿和组织激励进行量化。运用分层线性模型（HLM）研究组织层面和个人层面因素对离职意愿的影响，并分析个体与组织之间的相互作用。
研究发现，家庭医生的职业认同对离职意愿有显著的负向影响（β=-0.242，P<0.001）。社区卫生服务中心的组织激励水平对离职意愿有显著的负向影响（β=-0.173，P<0.001），且组织激励水平在个体职业认同影响离职意愿的过程中起显著的负向调节作用（β=0.004，P<0.05）。
增强家庭医生的职业认同可以降低其离职意愿，在组织激励较强的机构中，个人认同对离职意愿的影响会减弱。在家庭医生的培训阶段，培养强烈的个人职业认同、重视组织激励的作用并优化整体组织环境至关重要。
