北京市朝阳区社区医生工作满意度及相关因素分析

Job satisfaction of general practitioners in Beijing Chaoyang District and influencing factors

目的 了解北京市朝阳区社区医生的工作满意度情况,分析与满意度相关的因素,探讨改进措施.方法 于2015年6月对北京市朝阳区35个社区卫生服务中心的500名全科社区医生,通过互联网调查的方式,针对社区医生对职业、收入和执业环境的满意度进行调查,回收419例合格问卷.采用logistics回归分析的方法,计算各种因素在校正前后与医生满意度的相关性.结果 419名研究对象中女性为296人（70.6％）;中位年龄38岁,参加工作的中位时间15年;大学本科及以上学历为297人（70.9％）,每周接诊患者数量＞ 120人的为185人（44.2％）,每周满负荷工作时间＞40 h的为227人（54.2％）;主要工作为门诊诊疗的为179人（42.7％）,对于未来5年的职业规划选择继续深造的为180人（43.0％）.311人（74.2％）对职业感到非常满意或比较满意,124人（29.6％）对收入感到非常满意或比较满意,206人（49.2％）对执业环境感到非常满意或比较满意.多因素logistic回归分析显示,年龄＞40岁（OR=2.20,95％ CI：1.33～3.61）、每周工作负荷≤40 h（OR =2.70,95％ CI：1.67 ～4.36）及未来5年内打算继续深造（0R=2.21,95％ CI：1.35 ～3.63）是对职业满意度高的独立影响因素;年龄＞ 40岁（OR =2.03,95％ CI：1.28～ 3.21）、每周工作负荷≤40 h（OR=1.60,95％ CI：1.04 ～2.46）及未来5年内打算继续深造（OR =2.03,95％ CI：1.28～3.22）是对收入满意度高的独立影响因素;学历大专及以下（OR =2.14,95％ CI：1.37 ～3.36）、每周接诊患病人数＜90人（OR=1.78,95％ CI：1.18 ～2.69）、每周工作时间负荷≤40 h（0R=1.73,95％ CI：1.15 ～2.59）、主要工作不是门诊诊疗（OR=1.54,95％CI：1.02 ～2.31）及未来5年打算继续深造者（OR=1.75,95％ CI：1.16 ～2.63）是对执业环境满意度高的独立影响因素.多数被调查者认为目前基层社区医生的数量远少于需求.结论 多数社区医生普遍对自己的职业感到满意,但是对收入和执业环境比较不满意.社区医生认为可以通过增加医生和护士的数量来改善目前的职业环境.

Objective To investigate the job satisfaction of general practitioners in Beijing Chaoyang District and related influencing factors.Methods Total 500 general practitioners from 35 community health service centcrs in Chaoyang District were invited to join this web-based survey in June 2015,and valid response was obtained from 419 of them.Information on the satisfaction to their career,income and practicing environment were collected.Factors associated with job satisfaction were analyzed using Chi-square test and logistics regression respectively,before and after adjustment of common confounders.Results Among 419 responders,there were 296 females （70.6%） and 123 males （29.4%） with a median age of 38 years old and median working duration of 15 year;297 （70.9%） of them had college degree or above;185 （44.2%） of them saw 〉 120 patients per week and 227 （54.2%） of them worked 〉40 hour per week;179 （42.7%） of the responders worked at the outpatient clinics;180 （43.0%） of them were planning for further education in the next 5 years;311 （74.2%） of the responders were satisfied with their career,while only 124 （29.6%） of them were satisfied with their income,and 206 （49.2%） were satisfied with the practice environment.The multivariate logistic regression showed that age 〉40 year （OR =2.20,95% CI：1.33-3.61）,working 〈 40 hours per week （OR =2.70,95% CI：1.67-4.36）,and planning for further education in the next 5 years （OR =2.21,95% CI：1.35-3.63）were positively associated with career satisfaction;〉 40 year old （OR =2.03,95% CI：1.28-3.21）,working 〈40 hours per week （OR =1.60,95% CI：1.04-2.46）,and planning for further education in the next 5 years （OR =2.03,95% CI：1.28-3.22） were positively associated with satisfaction with the income;education lower than university （OR =2.14,95 % CI：1.37-3.36）,seeing 〈 90 patients per week （OR =1.78,95% CI：1.18-2.69）,working 〈 40 hours per week （OR =1.73,95% CI：1.15-2.59）,not working at outpatient clinic （OR =1.54,95% CI：1.02-2.31） and planning for further education in the next 5 years （OR =1.75,95% CI：1.16-2.63） were significantly associated with higher satisfaction with practice environment.Most of the responders thought that there was a shortage of primary care physicians.Conclusion General practitioners are generally satisfied with their careers,but are not satisfied with their income and practice environment in Beijing Chaoyang District.