安徽省全科医生对执业方式改革及执业满意度的调查研究

Investigation of the practice mode reform and satisfaction of general practitioners in Anhui province

目的:了解安徽省全科医生对执业方式改革及执业现状的满意度,并探讨影响因素。方法:采用自填式问卷调查,抽取安徽省基层医疗卫生机构(包括社区卫生服务中心及乡镇卫生院)50所,选取调查当日50所基层医疗卫生机构在岗的全科医生为问卷调查对象。调查内容包括卫生技术人员的基本情况、对执业方式改革的认知情况、与居民签约服务情况、对执业现状的满意度。结果:在387名全科医生中,有178人(46.00%)知晓医生可多点执业,有199人(51.42%)支持医生多点执业,有128人(33.07%)认为所在单位支持医生多点执业;有219人(56.59%)所在单位已经开展了与居民的签约服务;有228人(58.92%)支持居民签约服务;有244人(63.05%)赞成病人自由选择医生;有142人(36.68%)赞成医生自由选择病人。对目前执业状况,5个具体方面评价选择不满意的比例由高到低依次是奖金分配(37.98%)、工作负荷(36.69%)、医患关系(33.07%)、工作环境(27.91%)和工作内容(27.39%)。认为制约全科医生多点执业的主要因素依次是相关设施服务不健全(33.67%)、单位制度制约(32.81%)、工作压力大(12.51%)以及基层医生数量不足(17.29%)。结论:安徽省全科医生对执业方式改革的积极性较高,执业满意度不高,并存在各种制约全科医生多点执业的因素。应加大全科医生多点执业的相关设施服务建设,设置多点执业准入标准,引导全科医生多点执业;完善单位制度,合理制定绩效工资分配制度,提高全科医生的执业满意度。

Objective： To investigate the practice mode reform and satisfaction of general practitioners in Anhui province and its influencing factors. Methods： Using a self-administered questionnaire survey,a total of 50 primary medical and health institutions（ including the community health service center and township health center） were selected in Anhui. The basic information of the subjects,cognition of reform in practice,contract with the residents and satisfaction degree with the practice were investigated. Results：Among the 387 general practitioners,178（ 46. 00%） doctors knew that physicians can conduct in multi-site practice,199（ 51. 42%）doctors supported multi-site practice,128（ 33. 07%） doctors thought that their unit supported multi-site practice,219（ 56. 59%）doctors unit signed the contract service with the residents,228（ 58. 92%） doctors supported the contract services,244（ 63. 05%）doctors were in favor of patient selecting doctor,and 142（ 36. 68%） agreed with the doctor choosing patient. The proportions of dissatisfaction from high to low were bonus allocation（ 37. 98%）,working load（ 36. 69%）,doctor-patient relationship（ 33. 07%）,working environment（ 27. 91%） and working content（ 27. 39%） in turn. The main reasons restricting general practitioners＇ multi-site practice were the related facilities service imperfect（ 33. 67%）,unit system restriction（ 32. 81%）,heavy work pressure（ 12. 51%）,and lack of general practitioners（ 17. 29%） in turn. Conclusions： General practitioners in Anhui have high positivity in the reform of the practice and low satisfaction with practice,and many factors restrict the multi-site practice of general practitioners. Strengthening the related facilities construction of multi-site practice,setting the multi-site practice standard,guiding the multi-site practice,improving unit system and rational formulating assignment system can improve the satisfaction degree of general practitioners with practice.