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跨学科家庭医生团队成员在提供综合护理方面的动机偏好:一项最佳-最差尺度研究。

Motivational preferences of interdisciplinary family physician team members in delivering integrated care: a best-worst scaling study.

作者信息

Chen Weizhuo, Xiong Zihui, Yang Qiao, Xiao Wenqi, Chen Junyi, Zhong Sisi, Ye Ting

机构信息

School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan 430030, China.

Research Center for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, 13 Hangkong Road, Qiaokou District, Wuhan 430030, China.

出版信息

Fam Pract. 2025 Jun 4;42(4). doi: 10.1093/fampra/cmaf016.

Abstract

BACKGROUND

In China, integrated care is facilitated by interdisciplinary Family Physician Teams (FPTs) to extend primary care services without increasing physician numbers. However, the advancement of integrated care faces challenges due to insufficient motivators for Family Physician Team Members (FPTMs).

OBJECTIVE

To elucidate the motivational preferences of FPTMs within integrated care, highlighting preference heterogeneity across individuals with diverse demographic and professional characteristics.

METHODS

A cross-sectional study was conducted in November 2022 with 363 FPTMs at community health centers affiliated with seven hospitals in Shenzhen city. The study assessed motivational preferences using a best-worst scaling (BWS) questionnaire to collect data. Conditional logit and mixed logit models were employed to analyze overall preferences and heterogeneity.

RESULTS

The study revealed a strong preference for patient-centered motivators, particularly highlighting patient needs, trust level, and adherence as key motivators that are crucial in shaping the engagement of FPTMs with integrated care. Additionally, heterogeneity in preference patterns was observed based on sex, education level, and professional role. Specifically, male FPTMs, those with a master's degree or higher, and general practitioners demonstrated a significantly stronger preference for employment benefits and government resource allocation.

CONCLUSION

The findings highlight the preference of FPTMs for patient-level motivators, underscoring the importance of implementing a feedback mechanism to capture patients' perspectives on services. Policymakers are urged to develop tailored motivational structures that consider the varied preferences of team members across different roles, thereby motivating the provision of integrated care by FPTMs.

摘要

背景

在中国,跨学科家庭医生团队(FPTs)推动了整合照护,在不增加医生数量的情况下扩展了基层医疗服务。然而,由于家庭医生团队成员(FPTMs)的激励因素不足,整合照护的推进面临挑战。

目的

阐明整合照护中FPTMs的激励偏好,突出不同人口统计学和专业特征个体之间的偏好异质性。

方法

2022年11月对深圳市7家医院附属社区卫生中心的363名FPTMs进行了一项横断面研究。该研究使用最佳-最差尺度(BWS)问卷评估激励偏好以收集数据。采用条件logit模型和混合logit模型分析总体偏好和异质性。

结果

研究显示对以患者为中心的激励因素有强烈偏好,尤其强调患者需求、信任程度和依从性是塑造FPTMs参与整合照护的关键激励因素。此外,基于性别、教育水平和专业角色观察到偏好模式存在异质性。具体而言,男性FPTMs、硕士及以上学历者和全科医生对就业福利和政府资源分配的偏好明显更强。

结论

研究结果突出了FPTMs对患者层面激励因素的偏好,强调了建立反馈机制以获取患者对服务看法的重要性。敦促政策制定者制定量身定制的激励结构,考虑不同角色团队成员的不同偏好,从而激励FPTMs提供整合照护。

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