供方视角下家庭医生签约服务激励机制分析

Incentive system for medical staff engaged in contracted family doctor services from providers' perspective

目的本研究通过对山东省家庭医生的激励偏好以及对激励措施现状满意度分析,提出完善家庭医生激励机制的相关建议。方法于2017年采用多阶段分层随机抽样的方法,对山东省600名社区(行政村)的家庭医生团队医务人员抽样调查,采用描述性分析描述调查对象的人口学特征及激励偏好情况,采用χ2检验和秩和比(RSR)法分析不同特征人群的满意度。结果家庭医生激励偏好结果显示:偏好得分排名靠前的是提高收入水平(2 617.50分),促进自身发展(2 610.50分),提高工作保障水平(2 524.86分),与满意度结合分析发现2者的匹配度较差;不同地区、性别以及收入水平的家庭医生对激励现状的总体满意程度有差异(P <0.05),用秩和比法对不同地区激励措施满意度的综合评价结果排名为菏泽(0.906 3分)、潍坊(0.645 8分)、济南(0.447 9分)。结论经济因素是家庭医生最关切的激励因素,家庭医生的收入水平过低会弱化其他激励措施的激励效果。

Objective To analyze motivation preferences for and satisfaction to current incentive measures among medical staff engaged in contracted family doctor services and to propose suggestions for improving the incentive system. Methods We recruited 600 medical staff engaged in contracted family doctor services using stratified multistage random sampling in three municipalities with different economic development in Shandong province and conducted a questionnaire survey on motivation preferences for and satisfaction to incentive measures among the staff during 2017. Chi-square test and rank sum ratio (RSR) were adopted in data analyses. Results The top three motivation preferences among the staff were increasing income,promoting self-development,and improving job security,with the grading scores of 2 617.50,2 610.50, and 2 524.86. The consistent matches between motivation preferences and satisfaction to incentive measures were poor among the staff. The overall satisfaction to current incentive measures differed significantly by region of work,gender,and income level among the staff (all P < 0.05);the RSR scores for overall satisfaction to incentive measures for the staff in Heze,Weifang,and Ji'nan municipality were 0.906 3,0.645 8,and 0.447 9,respectively. Conclusion Economic factor is the most concerned incentive factors and low income could weaken effects other incentive measures among medical staff engaged in contracted family doctor services in Shandong province.