贵州省医联体内中西医师对多点执业政策认知与推行意愿的比较研究

Comparatively Studying on the Cognition and Implementation Willingness of Multi-Sited License Policy between Traditional Chinese and Western Medicine Doctors of Guizhou Medical Association

目的:了解贵州省医联体内中西医师对多点执业政策的认知与推行意愿的差异,为深化政策认知与提高政策执行意愿提供依据。方法:采用多阶段抽样方法,对贵州省某三甲西医综合医院和某三甲中医院牵头的两大医联体下部分医疗机构的相关科室医(技)师进行问卷调查。结果:西医类医师的政策不知晓率高于中医类医师(P<0.001),临床医师政策知晓率高于医技医师(P<0.001);中西医师在政策认知上的影响因素不同,性别与职称是西医师政策认知的影响因素,职称与工作单位等级是中医师政策认知的影响因素;政策推行意愿下,临床岗与医技岗的中西医师在政策推行意愿上差异有统计学意义(P<0.001),表现为中医临床医师比西医临床医师更愿意多点执业,西医医技医师比中医医技医师更愿意多点执业;中西医师在政策推行意愿上的影响因素不尽相同,但薪酬分配、职称晋升与政策认知均是影响中西医师政策推行意愿的因素。结论:中西医师在多点执业政策认知与推行意愿上存在差异,且中西医师在政策认知与推行意愿上的影响因素各不相同,应根据中西医师在政策认知与推行意愿上呈现的差异及其原因,具有针对性地做好政策宣传工作,并采取合理措施有效提高医师政策推行意愿。

Objective To understand the difference of cognition and implementation willingness of multi-sited license policy between the traditional Chinese and Western medicine doctors in Guizhou Medical Association,and provide the basis for deepening the policy cognition and improving the willingness of policy implementation.Methods A multi-stage sampling method was adopted to conduct a questionnaire survey on the medical(technical) doctors of some medical institutions in two medical associations led by a third-grade general western medicine hospital and a third-grade traditional Chinese medicine hospital in Guizhou Province.Results The policy ignorance rate of western medicine doctors was higher than that of traditional Chinese doctors(P<0.001).Clinicians’ policy awareness rate was higher than medical technicians(P<0.001).There were different influencing factors in policy cognition of traditional Chinese and western medicine doctors,which were gender and professional title for the western physicians,and professional title and institution’s level for the traditional Chinese medicine doctors.There was a significant difference between traditional Chinese and western medicine doctors in clinical posts and medical technology posts in willingness to implement the policy(P<0.001).It was manifested that traditional Chinese medicine clinicians were more willing to practice in multiple medical institutions than western medicine clinicians,while the medical technicians in western medicine were more willing to practice in multiple medical institutions than TCM medical technicians.The influencing factors to the willingness of implementing the policy were different between Chinese and western doctors,but the salary distribution,professional title promotion and policy cognition were the common influencing factors to implement the policy.Conclusion Traditional Chinese and western medicine doctors have differences in multi-sited license policy cognition and implementation willingness,and their influencing factors were different.It is suggested to intensify targeted policy publicity,and take reasonable measures to effectively improve the willingness of doctors to implement the policy.