广东省基层医疗卫生机构全科医生工作满意度及影响因素研究

Level and Associated Factors of Job Satisfaction in General Practitioners in Guangdong's Primary Care Settings

背景提升居民整体健康水平,建立完整的分级诊疗模式,需要大量的全科医生做支撑。截至2020年底,广东省全科医生数量达到3.13人/万人口,但这一群体的工作满意度尚未得到足够的关注和重视。目的调查广东省基层医疗卫生机构全科医生工作满意度现状,了解影响全科医生工作满意度的因素。方法研究者于2021年7月5—31日,采用多阶段分层整群抽样法对广东省8710例基层医疗卫生机构全科医生进行问卷调查。问卷内容包括全科医生的人口学信息与家庭医生团队服务情况,以及明尼苏达满意度问卷(MSQ)短式量表。使用SPSS 24.0软件通过多重线性回归分析模型识别全科医生工作满意度的影响因素。结果最终获得6006份有效问卷,问卷有效回收率为68.96%。广东省全科医生工作满意度平均得分为(3.70±0.87)分。满意度较高的前3位条目分别是“能够为其他人做些事情的机会”〔(4.03±0.64)分〕、“独立工作的机会”〔(4.02±0.69)分〕、“同事之间相处的方式”〔(3.99±0.61)分〕;满意度分值较低的条目分别为“收入与工作量”〔(2.98±1.04)分〕、“职位晋升的机会”〔(3.19±0.92)分〕、“工作表现出色时所获得的奖励”〔(3.39±0.93)分〕。多重线性回归结果显示,年收入、行政职务、在团队中是否处于核心地位、是否拥有二级及以上医疗机构专家号源、是否开展家庭病床服务、是否提供慢性病长处方服务、是否自学相关知识、是否与其他团队沟通并交流经验是基层医疗卫生机构全科医生工作满意度的影响因素(P<0.05)。结论广东省基层医疗卫生机构全科医生工作满意度处于较高水平。高收入、有行政职务、在团队中处于核心地位、有专家号源、开展家庭病床服务、提供慢性病长处方服务、自学相关知识、与其他团队沟通交流的全科医生工作满意度较高。

Background The improvement of the overall health of residents and the sound development of the hierarchical medical system require the support of a large number of qualified general practitioners(GPs).As of the end of 2020,the GPs-population ratio in Guangdong reached 3.13/10000,but the job satisfaction of GPs has not received enough attention.Objective To assess the level and determinants of overall job satisfaction among GPs in Guangdong's primary care settings.Methods A self-administered questionnaire survey was conducted with 8710 GPs selected from Guangdong's primary care settings by use of stratified,multistage cluster sampling from July 5th to 31st,2021.The information collected include GPs'demographics,and services of GPs'teams as well as job satisfaction assessed using Minnesota Satisfaction Questionnaire-Short Form(MSQ-SF).The determinants of job satisfaction were identified using the multiple linear regression model and analyzed using SPSS Statistics 24.0.Results The survey obtained a response rate of 68.96%(6006/8710).The overall satisfaction score of the respondent GPs was(3.70±0.87)points.The three highest-ranked items in terms of score were"The chance to do things for other people"[(4.03±0.64)points],"The chance to work aloneon the job"[(4.02±0.69)points],and"The way my co-workers get along with each other"[(3.99±0.61)points].The items scored relatively lower were"My pay and the amount of work I do"[(2.98±1.04)points],"The chances for advancement on this job"[(3.19±0.92)points],and"The praise I get for doing a good job"[(3.39±0.93)points].Multiple linear regression analysis found that annual income,administrative position,having a core position in the team,having privileged access to getting an appointment with experts working in secondary or tertiary medical institutions,providing long-term prescribing services for chronic diseases,delivering home sick-bed services,studying occupation-specific knowledge by oneself,and communicating with other teams for exchanging experience were associated with the job satisfaction of GPs(P<0.05).Conclusion In a word,the overall job satisfaction level of GPs in Guangdong's primary care settings was relatively high.High annual income,administrative position,having privileged access to getting an appointment with experts working in secondary or tertiary medical institutions,delivering home sick-bed services and long-term prescribing services for chronic diseases,having a core position in the team,studying occupation-specific knowledge by oneself,communicating with other teams for exchanging experience,were associated with higher level of job satisfaction.