Guo Botang, Li Yongbin, Fu Ying, Li Minyao, Wang Yue, Liu Shuyu, Zhou Yanjuan, Liu Yu, Tang Ping
Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, China.
Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Front Public Health. 2025 Jul 17;13:1633175. doi: 10.3389/fpubh.2025.1633175. eCollection 2025.
Ensuring the resilience and retention of the primary healthcare workforce is critical to maintaining health service continuity during public health crises. While pandemic preparedness frameworks increasingly emphasize integrated economic and health policies, the role of organizational and psychological factors in sustaining frontline health personnel has received less empirical attention. This study aimed to investigate the prevalence of turnover intention among community general practitioners (GPs) in Luohu District, Shenzhen, China, and to examine the mediating role of work engagement in the relationship between perceived organizational resilience and turnover intention.
A cross-sectional survey was conducted among 927 community health physicians from Aug to Dec in 2024 in Luohu District, Shenzhen, a region where all community health centers are governed by a unified hospital group. Participants completed validated scales assessing organizational resilience, work engagement, and turnover intention. Descriptive statistics, correlation analysis, and hierarchical regression analysis were performed. The mediating effect of work engagement was tested using bootstrapping procedures, controlling for significant demographic and occupational covariates.
A high prevalence of turnover intention was observed, with 65.16% of GPs reporting high or very high levels. Significant differences in turnover intention were found across age groups, professional titles, cadre status, monthly income, and perceived public health workload. Mediation analysis revealed that work engagement partially mediated the relationship between organizational resilience and turnover intention ( = -0.018, 95%CI [-0.070,-0.011] without covariates; adjusted indirect effect = -0.019, 95%CI [-0.026,-0.012] with covariates), accounting for approximately 16.82% (17.12% adjusted) of the total effect. These relationships remained significant after controlling for covariates.
Turnover intention among community GPs in the studied region is alarmingly high, posing a significant challenge to workforce stability. Organizational and psychological resources play a key role in mitigating workforce attrition risks in community health systems. Strengthening organizational resilience and fostering work engagement may offer cost-effective, non-technological strategies to maintain essential health service delivery capacity during future pandemics, aligning with broader goals of economic stability and pandemic preparedness.
确保基层医疗保健人员队伍的韧性和留存率对于在公共卫生危机期间维持卫生服务的连续性至关重要。虽然大流行防范框架越来越强调经济政策与卫生政策的整合，但组织因素和心理因素在维持一线卫生人员方面所起的作用却较少受到实证关注。本研究旨在调查中国深圳罗湖区社区全科医生（GP）离职意愿的普遍程度，并检验工作投入在感知到的组织韧性与离职意愿之间关系中的中介作用。
2024年8月至12月，对深圳罗湖区927名社区卫生医生进行了横断面调查，该地区所有社区卫生中心均由一个统一的医院集团管理。参与者完成了评估组织韧性、工作投入和离职意愿的有效量表。进行了描述性统计、相关性分析和分层回归分析。采用Bootstrap程序检验工作投入的中介效应，并控制显著的人口统计学和职业协变量。
观察到离职意愿的高发生率，65.16%的全科医生报告有高或非常高的离职意愿水平。不同年龄组、职称、干部身份、月收入和感知到的公共卫生工作量在离职意愿方面存在显著差异。中介分析表明，工作投入部分中介了组织韧性与离职意愿之间的关系（无协变量时β = -0.018，95%CI [-0.070，-0.011]；有协变量时调整后的间接效应β = -0.019，95%CI [-0.026，-0.012]），约占总效应的16.82%（调整后为17.12%）。在控制协变量后，这些关系仍然显著。
研究地区社区全科医生的离职意愿高得惊人，对劳动力稳定性构成重大挑战。组织资源和心理资源在降低社区卫生系统劳动力流失风险方面发挥着关键作用。加强组织韧性和促进工作投入可能提供具有成本效益的非技术策略，以在未来大流行期间维持基本卫生服务提供能力，这与经济稳定和大流行防范的更广泛目标相一致。
