北京市家庭医生激励水平评价及影响因素分析

Analysis of the incentive level and its influencing factors of family doctors in Beijing

目的分析北京市家庭医生的激励现状及其影响因素, 为推动家庭医生签约服务提供参考。方法 2021年10—12月, 选取北京市8个区所有社区卫生服务中心(135家), 从每家社区卫生服务中心随机抽取40名家庭医生进行问卷调查, 调查内容包括基本人口学信息、机构组织能力评价和家庭医生激励水平评价(包含工作价值、组织环境、个人发展和奖励报酬4个维度), 分析家庭医生激励水平的影响因素。采用χ2检验和Pearson相关性分析进行单因素分析, 采用多元线性回归分析进行多因素分析。结果共调查4 568名家庭医生, 其激励水平综合评分为(3.75±0.81)分。其中, 工作价值评分最高, 为(3.89±0.77)分, 其次为组织环境评分(3.69±0.92)分和个人发展评分(3.75±0.90)分, 奖励报酬评分最低, 为(3.46±1.00)分。年龄、文化程度、职称、工作年限和平均每周工作总时长负向影响家庭医生激励水平(P<0.05),平均月收入、参加培训和进修的频率以及机构组织能力正向影响家庭医生激励水平(P<0.05)。结论北京市基层医疗卫生机构家庭医生激励水平有待提高, 影响家庭医生激励水平的因素较多, 建议适当提高家庭医生薪酬待遇、合理安排家庭医生工作量、加强家庭医生培养机制以及强化基层医疗卫生机构组织能力建设。

Objective To analysis the incentive level of family doctors in primary medical and health institutions in Beijing,and to explore its influencing factors,so as to provide references for promoting family doctors′contract service.Methods From October to December 2021,40 family doctors were randomly selected from 135 urban community health service centers in 8 districts of Beijing,and a survey was conducted on basic demographic information,institutional organizational capacity evaluation,and family doctor incentive level evaluation(including four dimensions of work value,organizational environment,personal development,and reward compensation),and the influencing factors of family doctor incentive level was analyzed.Chi-square test and Pearson correlation analysis were used for univariate analysis,and multiple linear regression analysis was used for multivariate analysis.Results A total of 4568 family doctors were included,and the score of family doctors′incentive level was 3.75±0.81,among which the work value score was the highest(3.89±0.77),followed by the organizational environment score(3.69±0.92)and personal development score(3.75±0.90),and the lowest score was reward(3.75±0.90).Age,education,professional title,working years and average total working hours per week negatively affected the incentive level(P<0.05),while the average monthly income,the frequency of attending training and further study,and the organizational ability of the organization positively affected the incentive level(P<0.05).Conclusions The overall incentive level of family doctors in primary medical and health institutions in Beijing needed improvement,and there were many factors that affect the incentive level of family doctors.It was recommended to appropriately increase the salary and benefits of family doctors,reasonably arrange the workload of family doctors,strengthen the training mechanism of family doctors,and strengthen the organizational capacity building of primary medical and health institutions.