Mick S S, Sussman S, Anderson-Selling L, DelNero C, Glazer R, Hirsch E, Rowe D S
Med Care. 1983 Mar;21(3):323-37. doi: 10.1097/00005650-198303000-00005.
The objectives of this questionnaire study of all primary care physicians (N = 154) who had ever worked in eight New England prepaid group practices (PGPs) include 1) calculation of turnover rates, 2) comparison of those who stayed in (stayers) versus those who left (leavers) the PGPs, and 3) description of reasons given for leaving. An annual turnover rate of 3.9 to 6.3 per cent, depending upon the measure, was within the range reported by others. Factors associated with stayer-leaver status were experiences before and during the physician's PGP tenure. Leavers reported pre-PGP experience in fee-for-service, hospital-based, and academic positions, and while in the PGPs, they reported constraints on autonomy, independence, and professional development. Leavers reported higher incomes and longer working hours in their new practices. They cited the potential for greater autonomy as the reason for leaving. The findings and study limitations are discussed.
这项针对曾在新英格兰地区八家预付费团体医疗执业机构（PGP）工作过的所有基层医疗医生（共154人）开展的问卷调查研究，其目标包括：1）计算人员流动率；2）对比留在PGP的医生（留任者）和离开PGP的医生（离职者）；3）描述离职原因。根据不同衡量标准，年人员流动率在3.9%至6.3%之间，处于其他研究报告的范围内。与留任者 - 离职者状态相关的因素是医生在PGP任职之前及任职期间的经历。离职者报告称在按服务收费、医院及学术岗位有过PGP任职前的经历，而在PGP工作期间，他们表示自主性、独立性和职业发展受到限制。离职者报告称在新工作岗位上收入更高、工作时间更长。他们提到更大自主性的可能性是离职原因。文中讨论了研究结果及局限性。
