北京地区医务人员付出回报及影响因素分析

Analysis of Effort-Reward and Influencing Factors in Medical Staff in Beijing

目的探讨医务人员付出回报状况及影响因素,为调整付出回报提供参考。方法利用付出-回报失衡量表得分,计算北京市4156名医院、社区服务中心和乡镇卫生院医务人员付出-回报比指标并进行分类,使用logistics回归模型对不同因素对付出-回报失衡的影响。结果研究结果显示北京地区医务人员付出回报失衡比例达到65%,高于不同地区和不同行业水平。多因素logistics回归分析结果表明,女性付出回报失衡发生风险为男性的为1.38倍(95%CI:1.19~1.61);在婚者风险为非在婚者(包括未婚、离异和丧偶)者1.47倍(95%CI:1.23~1.76);与最高学历为博士者相比,学历越低,失衡风险越小;工龄每增加10年,付出回报失衡发生的风险因素增加26%(OR=1.26,95%CI:1.17~1.36);夜班次数增加付出回报失衡发生风险也随之增加。结论本研究结果显示北京地区医务人员付出回报失衡形势较为严峻,医疗机构管理层应采取针对性措施,解决医务人员中普遍存在的付出回报失衡问题。

Objective To explore the current status and influencing factors of effort-reward in medical staff,in order to provide reference for adjusting effortreward imbalance.Methods A total of 4156 medical staff from hospitals,community health service centers,and township hospitals in Beijing were included in the study and scored by effort-reward imbalance questionnaire.They were classified by the effort-reward imbalance(ERI)ratio.Logistic regression model was adopted to explore the factors influencing ERI.Results The percentage of ERI in the medical staff of Beijing was 65.0%,which was higher than that in other districts and industries.The results of multivariate logistics regression analysis showed that the ERI risk of women was 1.38 times that of men(95%CI:1.19-1.61);the ERI risk of the married was 1.47 times that of the unmarried(including unmarried,divorced and widowed)(95%CI:1.23-1.76);compared with those with the highest degree of Doctor,the lower the education level,the smaller the ERI risk;working years increased every 10 years,the ERI risk increased by 26%(OR=1.26,95%CI:1.17-1.36);the ERI risk increased with the number of night shifts.Conclusion This study shows that ERI is serious in the medical staff of Beijing.Necessary measures should be taken by the managers of medical institutions to solve the problem of ERI that are common among medical staff.