基于双因素激励理论的上海市奉贤区全科医生群体激励模型构建  

Development of an Incentive Model for General Practitioners in Fengxian District of Shanghai Based on Herzberg's Motivation-hygiene Theory

作　　者：潘丹英 顾春妹 曹伟艺 彭燕 唐燕 金佳慧 翁志贤 张洁 PAN Danying;GU Chunmei;CAO Weiyi;PENG Yan;TANG Yan;JIN Jiahui;WENG Zhixian;ZHANG Jie(Fengxian District Nanqiao Community Health Center,Shanghai 201400,China)

机构地区：[1]上海市奉贤区南桥镇社区卫生服务中心,201400

出　　处：《中国全科医学》2022年第7期837-845,共9页Chinese General Practice

基　　金：2018年度上海市奉贤区(社会类)科技发展基金项目(20181708)——基于双因素理论的社区全科医生人才激励现状调研与供给侧改革策略研究。

摘　　要：背景在全科人才紧缺、社区资源有限的背景下,社区卫生服务机构亟须找到精准而科学的“激励”方式,“留住人、用足人”,并促成组织与个人共同成长,进而利好社区居民。目的本研究通过构建全科医生群体激励机制模型,来检验现行政策的激励措施及其实际成效,以提出改进意见与建议,完善全科医生用人、留人机制。方法2019年8月,采用分层随机抽样方法从上海市奉贤区选取11家社区卫生服务中心的204例全科医生,邀请其填写“全科医生对激励措施的认知与评价现况调查问卷”;于2019年8—9月,邀请11家社区卫生服务中心的医疗业务分管主任/公共卫生业务分管主任、医疗质量控制科室负责人,填写“奉贤区社区卫生服务中心全科医生工作负荷调研表”。然后以赫兹伯格的双因素激励理论作为理论指导,以上海市奉贤区为研究范围,以区内全科医生为研究对象,将各级层面与激励相关的政策、制度和举措作为输入,将全科医生群体作为反应主体,提取有代表性的潜变量测量该群体的激励认知和激励评价,将全科医生群体的工作意愿、服务半径、工作量表现作为输出,建立全科医生群体激励机制模型。结果204例全科医生对激励措施落实情况评价的平均得分为(0.77±0.14)分,认为激励措施落实情况对自身工作状态影响的平均得分为(0.73±0.19)分。不同健康状况、是否为行政岗位的全科医生对激励措施落实情况的评分比较,差异有统计学意义(P<0.05);不同健康状况的全科医生对激励措施落实情况对自身工作状态影响的评分比较,差异有统计学意义(P<0.05)。Spearman秩相关分析结果显示,全科医生对25项激励措施(1项街镇层面的激励措施未分析)的评价和认为激励措施落实情况对自身工作状态的影响均具有相关性(P<0.05),其中相关性程度较高的前3条激励措施分别为绩效分配(r_(Background In view of the shortage of general practitioners(GPs)and limited community healthcare resources,it is urgently necessary for community health institutions to find accurate and scientific incentive methods to retain GPs and help them to realize their full potential,as well as promote the development of both community health institutions and GPs,thereby benefiting the health promotion of community residents.Objective To develop an incentive model for GPs to test the performance and effectiveness of current incentives for GPs,so as to put forward suggestions to improve the mechanisms of employing and retaining GPs.Methods In August 2019,we recruited 204 GPs from 11 community health centers(CHCs)in Shanghai's Fengxian District using stratified random sampling to attend an online survey using a questionnaire named General Practitioners'Perception and Evaluation of Incentive Measures developed based on our previous research results and Herzberg's motivation-hygiene theory.Then from August to September 2019,we invited directors responsible for medical care or public health issues,and medical quality control department heads from the above-mentioned 11 CHCs to attend an online survey using a questionnaire named Workload for General Practitioners in Community Health Centers of Fengxian District developed by usbased on a literature review.Then under the guidance of Herzberg's motivation-hygiene theory,we constructed a structural equation to develop an incentive model for GPs within Fengxian District with representative incentive policies,systems and initiatives related to GPs selected from the survey results as latent independent variables to measure GPs'(responders')perception and assessment of incentives,and with willingness to work,service radius,and workload of GPs as dependent variables.Results The average scores for the implementation of incentive measures,and its associated influence on GPs'work status assessed by the 204 GPs were(0.77±0.14),and(0.73±0.19),respectively.The assessment score for implement

关 键 词：全科医生 双因素激励理论 激励模型 结构方程 加权工作量 

分 类 号：R197[医药卫生—卫生事业管理]