上海市“长宁模式”下的家庭医生工作现状和职业满意度调查研究  

Investigation of the Current Working Condition and Career Satisfaction of the Family Doctors in " Changning Model" in Shanghai

作　　者：袁立[1] 周昌明[1] 江萍[2] 徐蕾 赵琦[1] 徐飚[1] 

机构地区：[1]复旦大学公共卫生学院,上海市200032 [2]上海市长宁区卫生局 [3]上海市长宁区社区卫生管理中心

出　　处：《中国全科医学》2014年第28期3391-3393,3398,共4页Chinese General Practice

基　　金：上海市加强公共卫生体系建设三年行动计划(2011-2013)(GWⅢ-24)

摘　　要：目的了解在"长宁模式"下家庭医生的工作现状和职业满意度情况,并探讨影响职业满意度的原因。方法整群抽取上海市长宁区2012年12月在职的所有家庭医生。于2012年12月—2013年1月,使用自行设计的调查问卷,对家庭医生进行面对面问卷调查。调查内容包括家庭医生的基本情况、家庭医生工作现状及职业满意度等。结果共发放问卷138份,回收有效问卷137份,问卷的有效回收率为99.3%。家庭医生的学历以本科为主,占71.5%;职称以中级为主,占72.3%。家庭医生平均签约561人,中位数为450人,常规服务内容涵盖了医疗服务、公共卫生服务、健康管理等多方面内容,排在前三位的服务内容分别为社区医疗、会诊和转诊,社区人群的健康管理,社区慢性病患者的系统管理,应答率分别为97.0%、95.5%和91.0%。对于目前从事全科医生岗位,有21.2%(29/137)的家庭医生明确表示不满意,42.3%(58/137)的家庭医生选择了一般,仅有36.5%(50/137)的家庭医生对从事该岗位表示满意或非常满意。结论家庭医生目前的常规服务涵盖了医疗服务、公共卫生服务、健康管理等多个方面;工作总体满意度较高,但各部分满意度相差较大。社区卫生服务模式转变为家庭医生搭建了防治一体化的服务平台,如何在新体制下减轻医生的职业压力、提高家庭医生的职业定位、完善家庭医生的职业规划、改善家庭医生的收入是当务之急。Objective To understand the current working condition and career satisfaction of family doctors in the ＂ Changning model＂ and explore the influencing reasons for doctors＇ career satisfaction.Methods All family doctors in Changning district,Shanghai were selected by clumster sampling,who were interviewed face to face between December,2012 and January,2013,by self- designed questionnaire about their basic condition,current working condition and career satisfaction.Results In total,138 questionnaires were handed out.137 valid questionnaires were collected and the effective rate was99.3%.Of all the family doctors,71.5% had a degree of Bachelor of Medicine and 72.3% were middle professional title; 561 on average signed a contract with a median value of 450; their routine service contents involved medical service,public health service,health management,and so on; three service contents ranked the first three places were 1.community medical service,consultation and referral 2.health management 3.chronic disease management; the response rates of the three were 97.0%,95.5% and 91.0% respectively.In the item of engaging in the post of general practitioner,21.2%（ 29 /137） chose ＂ not satisfied＂,42.3%（ 58 /137） chose ＂ so- so＂ and 36.5%（ 50 /137） chose ＂ satisfied or very satisfied＂.Conclusion The routine service of the family doctors involves medical service,public health service and health management service.The overall satisfaction is high,but big difference exists among various parts on satisfaction.Community service model transformation has established a platform of prevention being integrated with treatment for family doctors.It is urgent affairs as how to relieve family doctors of work pressure under the new system,increase their professional orientation,perfect their career planning and improve their family income.

关 键 词：家庭医生 工作负荷量 职业满意 

分 类 号：R197[医药卫生—卫生事业管理]