重庆市垫江县基层医疗机构发展困境分析

Analysis of development dilemma of primary medical institutions in Dianjiang County of Chongqing Municipality

目的探讨影响重庆市垫江县基层医疗机构人员对薪酬满意度的因素以及基层医疗机构建设存在的问题。方法2021年4—5月,采用整群抽样法从重庆市垫江县选取18个乡镇卫生院、社区卫生服务中心和部分村卫生室作为调查机构,并从中选取了垫江县6位院长、7名基层卫生机构人员作为访谈对象。调查问卷通过问卷星方式发放,访谈通过面对面进行。结果调查对象对年薪酬总额满意度评分为(2.46±1.12)分,56.7%的调查对象对年薪酬总额不满意。调查对象对薪酬组成结构满意度评分为(2.62±1.12)分,49.2%的调查对象对薪酬组成结构不满意。调查对象对薪酬年均增长水平评分为(2.38±1.10)分,59.8%的调查对象对薪酬年均增长水平不满意。每周工作时间不同的调查对象对薪酬满意度差异具有统计学意义(P<0.05)。二元Logistic回归分析结果显示:每周工作时间是影响调查对象薪酬满意度的独立因素(P<0.05)。访谈人员均表示基层医疗机构面临问题主要是人员待遇差、工作量大、薪酬机制不合理、人才流失大等。结论提高基层医疗机构人员补贴水平、减少基层医疗机构人员加值班时间、加强对基层医疗机构的设施建设、适当放宽职称评定条件以及简化人才招聘程序,以保证人才队伍的引进和稳定。

Objective This aims to explore the factors for the degree of satisfaction with salary and the existing problems in the construction of primary medical institutions in Dianjiang County of Chongqing Municipality.Methods From April to May 2021,18 town and township health centers,community health centers,and some village clinics were selected from Di-anjiang County by cluster sampling.A total of 6 presidents,leaders of relevant hospitals,and 7 personnel of primary health institutions in Dianjiang County were selected as interview participants.Questionnaires were distributed through the Wen-juanxin platform and interviews were conducted face-to-face.Results The satisfaction score of the respondents with the to-tal annual salary was(2.46±1.12)points,and 56.7%of the respondents were dissatisfied with it.Respondents'satisfac-tion with the salary composition structure was(2.62±1.12)points,and 49.2%of respondents were dissatisfied with it.Respondents'score of the average annual salary growth was(2.38±1.10)points,and 59.8%of respondents were dissatis-fied with it.Respondents with different working hours per week showed a significant difference in the degree of satisfaction with salary(P<0.05).Binary logistic regression analysis showed that weekly working hours was an independent factor for respondents'degree of satisfaction with salary(P<0.05).Interviewers held that primary medical institutions face problems mainly including poor compensation package,heavy workload,unreasonable distribution of salary mechanism,and large brain drain.Conclusion In primary medical institutions,improving the subsidy level,reducing the overwork and duty time,strengthening the facility construction,appropriately relaxing the conditions for professional title evaluation,and simplifying the talent recruitment procedure can ensure the introduction and stability of talent teams.