乡村一体化改革对乡村医生组织支持感的影响研究——以山西省紧密型县域医共体为例  

Study on the impact of rural integration reform on the sense of organiza-tional support of rural doctors———a case study of compact county medi-cal community in Shanxi Province

作　　者：张含璇 李建涛 原效国 牛保珠 魏美琪 程蒙 马阳阳 ZHANG Han-xuan;LI Jian-tao;YUAN Xiao-guo;NIU Bao-zhu;WEI Mei-qi;CHENG Meng;MA Yang-yang(School of Management,Shanxi Medical University,Taiyuan,Shanxi 030001,China;不详)

机构地区：[1]山西医科大学管理学院,山西太原030001 [2]山西省卫生健康委员会,山西太原030001

出　　处：《现代预防医学》2022年第20期3753-3758,共6页Modern Preventive Medicine

基　　金：山西省软科学研究计划项目(2019041049-1);山西省高等学校人文社会科学重点研究基地项目(201801018)。

摘　　要：目的了解紧密型县域医共体背景下乡村医生组织支持感情况,分析“乡村一体化”改革对乡村医生组织支持感的影响。方法使用组织支持感量表对目的抽样和多阶段整群随机抽样选取的山西省417名乡村医生进行调查,运用描述性分析、t检验、多元线性回归分析、访谈法对村医相关数据进行分析。结果乡村医生组织支持感总得分为(3.30±0.534);三县中组织支持感总平均得分最高为全部实行乡村一体化改革的W县(3.47±0.449),部分乡镇实行乡村一体化管理的J县次之(3.42±0.477),未实行乡村一体化管理的Y县最低(3.00±0.547)。J县与Y县以及Y县与W县的总体组织支持感(t_(JY)=6.752,t_(YW)=-7.878)、感受的组织支持(t_(JY)=4.628,t_(YW)=-5.874)、情感支持(t_(JY)=5.127,t_(YW)=-5.450)、组织奖励(t_(JY)=15.397,t_(YW)=-18.240)、上级支持(t_(JY)=2.745,t_(YW)=-3.041)维度得分的组间差异性显著(P<0.01),J县和W县得分均高于Y县。多元线性回归结果显示,实验组Ea、Eb组织支持感总得分分别高于对照组Ca、Cb,差异具有统计学意义(t=8.319、P<0.01,t=2.969、P=0.004)。结论相较于其他医务人员,紧密型县域医共体背景下乡村医生组织支持感整体较低,其中未实行“乡村一体化”管理地区的村医尤甚;“乡村一体化”改革会增加乡村医生组织支持感。Objective To understand the organizational support of rural doctors in the context of a close county-level medical community,and to analyze the impact of the“rural integration”reform on the organizational support of rural doctors.Methods A survey of 417 rural doctors in Shanxi Province,selected by purpose sampling and multi-stage cluster random sampling,was conducted using the Organizational Support Scale.Descriptive analysis,t-test,multiple linear regression analysis,and interview were used to analyze the relevant data of village doctors.Results The total score of organizational support among rural doctors was 3.30±0.534.Among the three counties,the total average score of organizational support was the highest in W county(3.47±0.449),followed by J county(3.42±0.477),and the lowest in Y county(3.00±0.547).Overall perceived organizational support(t_(JY)=6.752,t_(YW)=-7.878),perceived organizational support(t_(JY)=4.628,t_(YW)=-5.874),emotional support(t_(JY)=5.127,t_(YW)=-5.450),organizational reward(t_(JY)=15.397,t_(YW)=-18.240)and superior support(t_(JY)=2.745,t_(YW)=-3.041)had significant differences among groups(P<0.01).The scores of J county and W county were higher than those of Y county.Multiple linear regression results showed that the total scores of Ea and Eb in the experimental group were higher than those of Ca and Cb in the control group,with statistically significant differences(t=8.319,P<0.01;t=2.969,P=0.004).Conclusion Compared with other medical staff,under the background of compact county medical community,the sense of organizational support of rural doctors is lower as a whole,especially in the areas where“rural integration”is not implemented,and the reform of“rural integration”will increase the sense of organizational support of rural doctors.

关 键 词：乡村一体化 乡村医生 组织支持感 

分 类 号：R192.5[医药卫生—卫生事业管理]