不同收入水平地区三级公立医院医生的核心胜任力现状:横断面调查研究  

Core competency of doctors at tertiary public hospitals in regions of different income levels in China:a cross-sectional survey

作　　者：何紫棠 李玥 胡耀达 张国杰 李莉[5] 孙家林 罗林枝 吴振龙 单广良[3] 张抒扬[8] He Zitang;Li Yue;Hu Yaoda;Zhang Guojie;Li Li;Sun Jialin;Luo Linzhi;Wu Zhenlong;Shan Guangliang;Zhang Shuyang(Education Department,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China;Gastroenterology Department,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China;Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences,School of Basic Medicine,Peking Union Medical College,Beijing 100005,China;Medical Department,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China;Outpatient Department,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China;Finance Department,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China;Chinese Medical Doctor Association,Beijing 100027,China;Department of Cardiology,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院、北京协和医院教育处,北京100730 [2]中国医学科学院、北京协和医院消化内科,北京100730 [3]中国医学科学院基础医学研究所、北京协和医学院基础学院,北京100005 [4]中国医学科学院、北京协和医院医务处,北京100730 [5]中国医学科学院、北京协和医院门诊部,北京100730 [6]中国医学科学院、北京协和医院财务处,北京100730 [7]中国医师协会,北京100027 [8]中国医学科学院、北京协和医院心内科,北京100730

出　　处：《中华医院管理杂志》2023年第6期442-448,共7页Chinese Journal of Hospital Administration

基　　金：中国工程院咨询研究项目(2019-ZD-24)。

摘　　要：目的探究我国不同收入水平地区三级公立医院医生核心胜任力现状,为我国医生核心胜任力提升及相关政策制定提供参考。方法采用多阶段分层整群抽样方法,于2021年11月至2022年3月选取全国16个省份的195家三级公立医院,按照每家医院抽取200人的原则抽样,运用自行设计的问卷对医生的核心胜任力现状,以及毕业后医学教育和继续医学教育现状开展调查。依据《中国统计年鉴2022》中各省人均地区生产总值将各省份分为高、中、低收入地区,对问卷数据进行描述性分析,并采用χ2检验比较组间差异。结果共回收有效问卷32673份。我国接受了全面的各维度核心胜任力教育和培训的医生有12135人(37.14%);被调查对象自评核心胜任力不足的各维度中教学能力不足的有10019人(30.66%),职业素养维度不足的有438人(1.34%),且地区之间差异无统计学意义(P>0.05);高、中、低收入地区终身学习维度自评不足的医生分别有2385人(27.08%)、2528人(27.55%)和3646人(24.82%),中、高收入地区医生占比高于低收入地区(P<0.05);高、中、低收入地区知识技能维度自评不足的医生分别有1317人(15.57%)、1290人(14.06%)和2719人(18.51%),低收入地区医生占比高于中、高收入地区(P<0.05)。低收入地区未接受过任何一种毕业后医学教育或继续医学教育的医生占比为7.33%(1077人),高于高、中收入地区(P<0.05);高收入地区被调查医生认为住院医师规范化培训(以下简称住培)"带教医生精力投入不足"者占50.44%(4442人),高于中、低收入地区(P<0.001);中等收入地区认为住培、专科医师规范化培训(以下简称专培)"学员待遇过低"者分别占46.16%(4235人)和43.46%(3987人),认为"学员临床操作机会有限"者分别占42.47%(3897人)和30.44%(2793人),皆高于高、低收入地区(P<0.001);低收入地区被调查医生认为住培"培训基地投入不足"者占34.91%(5128人)、专培"�Objective To explore the core competency of doctors in tertiary public hospitals in regions of different income levels in China,and provide reference for promoting such competency and related policy formulation.Methods Using multi-stage stratified cluster sampling method,195 tertiary public hospitals in 16 provinces of China were selected from November 2021 to March 2022.200 doctors were sampled from each hospital.A self-designed questionnaire was used to investigate the status of doctors′core competencies,as well as the status of their postgraduate medical education and continuing medical education.According to the per capita gross regional product of each province in China Statistical Yearbook 2022,each province was divided into high,middle and low income regions,and the questionnaire data were descriptively analyzed,whileχ2 test was used to compare the differences between groups.Results A total of 32673 valid questionnaires were collected.There were 12135 doctors(37.14%)in China who had received comprehensive education and training of core competency in all dimensions.Among the dimensions of self-rated core competency of the surveyed doctors,there were 10019 doctors(30.66%)with insufficient teaching ability and 438(1.34%)with insufficient professional quality,and there was no significant difference between regions(P>0.05).There were 2385(27.08%),2528(27.55%)and 3646(24.82%)doctors in high-,middle-and low-income regions with insufficient lifelong learning ability,respectively.The proportion of doctors in middle-and high-income regions was higher than that in low-income ones(P<0.05).There were 1317(15.57%),1290(14.06%)and 2719(18.51%)doctors with insufficient knowledge and skills in high-,middle-and low-income areas,respectively.The proportion of doctors in low-income regions was higher than that in middle-and high-income regions(P<0.05).The proportion of doctors who did not receive any kind of postgraduate medical education or continuing medical education in low-income regions was 7.33%(1077 people),higher t

关 键 词：医院 公立 三级医院 医生 核心胜任力 毕业后医学教育 继续医学教育 

分 类 号：R197.322[医药卫生—卫生事业管理]