医药分开综合改革对某三甲口腔专科医院医师工作状况的影响

The Influence of the Comprehensive Reform of the Separation of Medicine on the Work of Doctors in a Tertiary A Stomatological Hospital

目的分析医药分开综合改革对某三甲口腔专科医院临床医师工作状况的影响。方法采取分层随机抽样方法,选取2018年6~8月北京市某三甲口腔专科医院164名医师进行问卷调查,分析医改革对临床医师工作状况的影响。结果164名医师,主要集中于31~40岁年龄段,来院工作时间主要以11~20年为主,专业技术职务主要以中级职称为主,受教育程度主要以硕士研究生及以上学历为主。在接诊量方面,其中没有变化和有增加的占比基本一致,仅7.93%认为接诊量有减少;关于接诊病种,主要以没有变化人数居多;在收入及绩效分配方面,57.92%的医师医事服务费能够体现劳动价值,53.04%的医师认为绩效收入有增加;在绩效分配原则的知晓程度上,大部分清楚或一般了解的医师较多,均占39.02%;在医改后对医师心理影响方面,48.78%的医师认为工作压力有所增加,仅有1.83%认为压力有所减缓,另有48.78%的医师需要身心健康培训;在医改支持方面,79.87%的医师对医改持支持态度,仅1.21%的医师对医改持否定态度。结论随着公立医院改革的不断推进,多数医生认为工作量及工作压力有增加,认为医事服务费能够体现医师的劳动价值,对医改政策持支持与拥护态度。医疗机构应进一步明确功能定位,逐步完善院内的绩效激励体系,引导临床医务人员不断提升自身的临床诊疗能力,在诊疗工作中更好地体现自身的价值。

Objective To analyze the impact of the comprehensive reform of medical division on the working status of clinicians in a tertiary A stomatological hospital.Methods A stratified random sampling method was used to select 164 physicians from a top three stomatological hospitals in Beijing from June to August 2018 to conduct a questionnaire survey to analyze the impact of medical reform on the working status of clinicians.Results 164 doctors,mainly concentrated in the age group of 31~40 years old.The working hours of the hospital are mainly from 11 to 20 years.The professional and technical positions are mainly called middle-level positions.The degree of education is mainly master degree and above.In terms of the number of consultations,there is no change and the proportion of the increase is basically the same.Only 7.93%believes that the number of consultations has decreased;regarding the types of consultations,the number of people who have not changed is the majority;in terms of income and performance distribution,57.92%the medical service fee of doctors can reflect the labor value.53.04%of doctors believe that performance income has increased;in terms of the knowledge of the performance distribution principle,most of the doctors who know clearly or generally understand more,accounting for 39.02%;In terms of psychological impact,48.78%of doctors believe that work pressure has increased,and only 1.83%believe that the pressure has been reduced.Another 48.78%doctors need physical and mental health training;in terms of medical reform support,79.87%of doctors support the medical reform,Only 1.21%of physicians hold a negative attitude towards medical reform.Conclusion With the continuous advancement of public hospital reforms,most doctors believe that the workload and work pressure have increased,that medical service fees can reflect the labor value of doctors,and support and support the medical reform policy.Medical institutions should further clarify their functional positioning,gradually improve the hospital's performance incentive system,guide clinical medical staff to continuously improve their clinical diagnosis and treatment capabilities,and better reflect their own value in diagnosis and treatment.