武汉市公立医院住院医师规范化培训学员急诊工作偏好及其影响因素

Preferences and Influential Factors of Emergency Department Work Among Trainees in the Standardized Training of Resident in Public Hospitals in Wuhan City

目的:了解武汉市公立医院住院医师规范化培训学员(以下简称“规培生”)对急诊工作的偏好及影响因素,为吸引和稳定公立医院急诊人才提供参考。方法:运用离散选择实验法设计问卷,调查武汉市8家三级甲等公立综合医院规培生,应用混合logit模型分析规培生对急诊工作的偏好及影响因素。结果:规培生最关注的工作属性依次为月收入增幅、每周夜班数量和执业风险程度(P<0.05);交互分析表明,男性、喜欢急诊学科、满意急诊待遇、愿意从事急诊工作的规培生对多夜班、高风险急诊工作持正向偏好;在不同政策干预下,当月收入增幅达到50%时,规培生选择急诊工作的概率变化最大(提高63.48%)。结论:规培生对急诊工作的偏好主要受月收入增幅、每周夜班数量与执业风险程度的影响且不同类别规培生之间差异较大,建议公立医院通过实行以班次、疾病权重、技术权重为主的绩效改革,结合精益管理理念与数字技术应用来建立高效安全的急诊平台,不断探索和改革规培模式,落实规培生的职业发展规划与指导,从而更好地吸引和留住急诊人才。

Objective:To understand the preference and influencing factors of rainees in the standardized training of resident in public hospitals for emergency work in Wuhan,so as to provide a reference for attracting and stabilizing emergency talents in public hospitals.Methods:The questionnaire was designed with the discrete choice experiment method to investigate the trainees in 8 Class-A tertiary public general hospitals in Wuhan.The mixed logit model was used to analyze the trainees'preferences for emergency work and the influencing factors.Results:The most concerned job attributes of the planned trainees are:the increase of monthly income,the number of night shifts per week,and the degree of practice risk(P<0.05).The interactive analysis shows that male trainees who like emergency disciplines,are satisfied with emergency treatment,and are willing to engage in emergency care have a positive preference for multi night shift and high-risk emergency work.Under the intervention of different policies,when the monthly income growth reaches 50%,the probability of regular trainees choosing emergency work changes the most(63.48%increase).Conclusion:The preference of regular trainees for emergency work is mainly affected by the increase of monthly income,the number of night shifts per week and the degree of professional risk,and there is a large difference between different types of regular trainees.It is suggested that public hospitals should carry out performance reform focusing on shift,disease weight and technology weight,combine lean management concept and digital technology application to establish an efficient and safe emergency platform,constantly explore and reform the training mode,and implement the career development planning and guidance of training students,so as to better attract and retain emergency talents.