公立医院医生新医改前后满意度的比较  

Comparison of work well-being among physicians in public hospitals before and after the new health reform

作　　者：黄冬梅[1] 尹文强[1] 于倩倩[1] 孙葵[1] 郭洪伟[1] 赵延奎[1] 

机构地区：[1]潍坊医学院管理学院,山东省潍坊市261053

出　　处：《中华医院管理杂志》2015年第3期217-220,共4页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金（70573078、71103129）;教育部人文社会科学研究规划项目（09YJA630114）;山东省教育厅资助项目（J11WG24）

摘　　要：目的：分析新医改前后公立医院医生工作状态及执业环境的变化。方法2007年和2011年分别调查医生1520人和1910人,利用构成比和双变量相关进行数据分析。结果两次调查相比,对工作表示满意者减少6.8%。认同“工作自主权”者减少21.1%,处于“疲劳”状态者增加5.1%；有“被患者信任感”者 减 少21.1%；对社会地位满意者减少9.1%,对媒体报道认同率上升12.3%。2007年与工作满意度相关最强的5个问题是“收入分配公平”“技术劳务价值体现”“收入付出相称”“职称评定公平”和“医改政策”（相关系数 r 分别为0.53、0.51、0.52、0.51、0.45,P 值均〈0.01）,2011年则为“患者信任”“医疗诉讼”“收入分配公平”“医改政策”和“纠纷处理”（相关系数 r 分 别 为0.50、0.50、0.50、0.49、0.48,P 值均〈0.01）。“媒体报道”关注度上升最明显（相关系数 r 由0.04上升到0.45）。结论新医改鼓舞医生效果不明显。患者“高期望、低信任”倾向突出,医疗风险压力大,医生“疲劳高危”的工作状态没有改观。重塑医患信任、分散职业风险、改善执业环境是鼓舞医生的关键。Objective To compare the work well-being among physicians between two surveys （2007 and 201 1 ）performed in public hospital of Shandong province.Methods The constituent ratios and Pearson correlation coefficient of two surveys with 1 520 and 1 910 respondents were compared.Results The proportion of satisfied physicians decreased from 6.8% between the two surveys.Those approving＂work autonomy＂ dropped 21.1%;those satisfied with their social standing dropped 9.1%,and those recognizing media coverage increased 12.3%.In year 2007,the top five issues most concerned with work satisfaction were＂income equity＂,＂embodiment of professional value＂,＂balance between income and workload＂,＂equity of academic title appraisal＂,and＂health reform policy＂ （r were 0.53,0.5 1,0.52, 0.5 1,and 0.45,with P average〈 0.01 ）.While in year 201 1,the top five issues most concerned with work satisfaction were ＂patient turst＂,＂medical lawsuit＂,＂income equity＂,＂health reform policy＂,＂dissension dealing＂（r were 0.50,0.50,0.50,0.49,0.48 ）.Attention to ＂medical reports＂ rising the most （r from 0.04 to 0.45）.Conclusion There was little positive change on physicians＇work well-being before and after new health reform while physicians are bearing ＂tiredness and high risk＂ under ＂high expectation and low trust＂.Rebuilding the patients＇trust,dispersing risks of the medical profession and improving the practicing environment are the keys to motivating physicians.

关 键 词：新医改 医生满意度 执业环境 医患关系 收入合理性 

分 类 号：R197.1[医药卫生—卫生事业管理]