我国医生执业能力自评情况及影响因素分析  

Analysis on self-evaluation of Chinese physicians′competency and its influencing factors

作　　者：纪婷婷[1] 葛晓娟[2] 林婷婷 彭博 尹金风 罗翔予 张鹏俊[5] Ji Tingting;Ge Xiaojuan;Lin Tingting;Peng Bo;Yin Jinfeng;Luo Xiangyu;Zhang Pengjun(Beijing Chest Hospital,Capital Medical University,Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149,China;Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;Institute of Medical Information/Medical Library,CAMS&PUMC,Beijing 100020,China;School of Statistics,Renmin University of China,Beijing 100872,China;Scientific Research Department,Beijing Hospital,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京胸科医院,北京市结核病胸部肿瘤研究所,101149 [2]首都医科大学附属北京佑安医院人事处,100069 [3]中国医学科学院医学信息研究所,北京100020 [4]中国人民大学统计学院,北京100872 [5]北京医院科研处,100730

出　　处：《中华医院管理杂志》2021年第1期10-14,共5页Chinese Journal of Hospital Administration

基　　金：中国工程院咨询研究项目(2017-XZ-21);北京市医院管理中心"青苗"计划专项(QML20191602)。

摘　　要：目的了解我国医生执业能力现状并对其影响因素进行分析,为有效提高我国医生的执业水平提供循证依据。方法参考国际成熟评价框架制定我国医生执业能力评价量表。2018年6—12月,采用分层抽样方法,依托医联体平台,随机选取全国13个省(自治区、直辖市)的39家医院,共2156名医生参与调查。对其执业能力6个维度(医学知识、疾病诊疗、科研教学、人际沟通、职业精神、群体健康)的现状和影响因素进行统计分析。单因素分析采用χ2检验,多因素分析采用二分类logistic回归分析。结果我国医生各维度执业能力自评结果显示,职业精神维度评分最高(3.89分),科研教学维度最低(2.85分)。logistic回归分析显示,医生6个维度的执业能力水平高低与性别、学历、职称、导师资格、专科医师规范化培训以及是否为医学院校附属医院或教学医院等有关(P<0.05)。结论我国医生执业能力总体尚待提升。科研教学能力存在短板,医生应开展以临床问题为导向的科学研究;知识结构还需丰富,医生应树立大健康理念;非技术服务能力尚有欠缺,医生应具有厚重的人文情怀;接受医学教育的程度决定医生执业能力高低,保证规范化培训质量是关键举措。Objective To understand the current situation of physicians′competency in China and statistically analyze its influencing factors,hence providing referential evidences for promoting their competency.Methods The evaluation scale for Chinese physicians′competency was developed by referring to sophisticated overseas evaluation frameworks.Based on the electronic platform of the medical alliance,stratified sampling was conducted at 39 hospitals in 13 provinces,from which 2156 physicians were surveyed,and statistical analysis was made on the current situation and influential factor of their competency in 6 dimensions(medical knowledge,diagnosis and treatment,scientific research and teaching,interpersonal communication,spirit of professionalism,population health)Results The score range in multiple dimensions of physicians′competency was between 2.85 and 3.89(5 in total),among which spirit of professionalism dimension scores the highest,and teaching and research dimension scores the lowest.Logistic regression analysis shows that their competency level in 6 dimensions is correlated to a range of factors,including gender,degree,title,supervisor qualifications,standardized training program of specialist physicians,and affiliation or not to teaching hospitals(P<0.05).Conclusions Their overall competency is expected to be elevated.To name a few,they are lack of teaching and research abilities,and need to conduct clinical-oriented scientific research;they are expected to enrich knowledge structure,and need to embrace a wider concept of health;they need to improve their non-technical service abilities,and should further emphasize their humanistic quality;physicians′practice competency depends upon their extent of medical education,and ensuring the quality of standardized training becomes the key measure.

关 键 词：卫生人力 医生 执业能力 自评 影响因素 

分 类 号：R192.3[医药卫生—卫生事业管理]