新医改背景下村医执业现状及职业前景预期影响因素分析——以湖南省5个地级市为例  

Analysis on influencing factors of practice situation and expectation of career prospects of rural doctors under new the background of medical reform——Take 5 prefectures and cities in Hunan Province as an example

作　　者：沈玮玮 黄超[1] 闫春晓[1] 周良荣[1] SHEN Wei-wei;HUANG Chao;YAN Chun-xiao;ZHOU Liang-rong(Hunan University of Chinese Medicine,Changsha Hunan 410208,China)

机构地区：[1]湖南中医药大学,湖南长沙410208

出　　处：《卫生软科学》2020年第6期3-7,共5页Soft Science of Health

基　　金：湖南省社科基金决策咨询重大专项:湖南省城乡居民以来经济负担现状调查及改善对策研究(16JCA004);2019年湖南省教育厅课题:中医药助力精准扶贫绩效评价指标体系研究(CX20190554)。

摘　　要：[目的]了解新医改背景下村医的执业现状,探讨影响其职业前景的预期关键因素,为稳定村医队伍提供依据。[方法]2018年7-8月采用分层方便抽样方法抽取湖南省5个地级市的370名村医作为调查对象,使用课题组编制的《村医职业偏好调查表》和《村医访谈提纲》为测量工具进行问卷调查,采用Logistic回归分析其职业前景的预期影响因素。[结果]调查的370名村医的平均年龄为47岁;月均收入2716元,月均医疗收入1943元;45.95%的村医日均工作时长超过14 h;有256名(69.19%)村医未参加养老保险。Logistic回归分析结果显示,性别、从医年限、月均医疗收入、养老保险、教育培训、社会地位评价、基层医改评价是影响医生职业前景预期的因素(P<0.05)。[结论]村医总体年龄偏大、收入低,养老未得到有效保障。女性、从医年限久、月均医疗收入多、有养老保险、参加过教育培训、对社会地位满意、对基层医改满意的村医对职业前景预期更为看好。Objective To understand present practice situation of rural doctors under the background of new medical reform,discuss key factors of affecting their expectations of career prospects so as to provide basis for stabilizing rural doctors team.Methods From Jul.to Aug.2018,a stratified and convenient sampling method was adopted,and 380 rural doctors were selected from five prefecture and cities in Hunan Province.“Rural Doctor Occupational Preference Questionnaire”and“Rural Doctor Interview Outline”edited by the research group which were used to measurement tools for questionnaire survey,and logistic regression analysis was used for analysis of influence factors of their expectations of career prospects.Results The average age of 370 rural doctors was 47 years old,average monthly income was 2,716 yuan,monthly average medical income was 1943 yuan.Average daily working hours of 45.95%rural doctors were over 14 hours.256(69.19%)of rural doctors did not participate in endowment insurance.Logistic regression analysis showed that gender,the years of to be doctor,monthly average medical income,endowment insurance,education and training,social status evaluation,and grassroots medical reform evaluation were influencing factors of affecting their expectations of career prospects(P<0.05).Conclusions Rural doctors are general old,low income,and no effective protection for the pension.The village doctors of female,longer to be doctor,more monthly medical income,with endowment insurance,with education and training,satisfied with social status,and satisfied with grassroots medical reform have better expectation of career prospects.

关 键 词：村医 职业前景预期 LOGISTIC回归分析 

分 类 号：R192[医药卫生—卫生事业管理]