医生执业环境满意度的结构方程模型研究

Medical practicing environment satisfaction of physicians in public hospitals： a structural equation modeling study

目的了解公立医院医生执业环境满意度影响因素，据此提出政策建议，优化医疗执业环境，提高医生的工作满意度。方法对5677名公立医院医生进行执业环境满意度调查，运用结构方程模型对执业环境满意度影响因素进行分析。结果公立医院医生对执业环境的总体满意度为（2．86±1．09）分；有33．8％的被试对医疗执业环境表示满意；制度环境对执业环境满意度的影响最大（β=0．772，P〈0．01），医患沟通次之（β=0．096，P〈0．01），社会舆论对执业环境满意度的影响差异无统计学意义。结论提高医生对执业环境的满意度应以健全宏观制度环境为重点。

Objective To explore the status quo and key factors of practicing environment satisfaction of doctors in public hospitals and then to put forward related policy suggestions. Methods Basing on a sample of 5677 physicians from public hospitals in Shandong, Neimenggu, Hebei and Hubei provinces, this paper conducted an empirical study on medical practicing environment satisfaction. Data were analyzed by structural equation modeling （SEM）. Results The informants were dissatisfied with current medical practicing environment （2.86 ± 1.09）, only 33.8 per cent of them expressed satisfaction with the current medical practicing environment. The standard regression coefficients of macro-institutional enviroment and communication between physician and patient on practicing environment satisfaction were significant（β = 0. 772,0. 096, P 〈 0.01 ）, while the regression coefficient of social consensus was insignificant. Conclusion Policy emphases should be put on improving macro-institutional enviorment to increase physicians＇ satisfaction.