摘要
目的通过探讨镇村卫生服务一体化管理对提升乡村医生职业认同和离职意愿的作用,梳理乡村医生队伍存在的问题,为建设一支稳定的、高素质的村医队伍提供理论支持。方法对全市10个涉农地区2652名乡村医生进行调查,对其人口学特征、一体化管理认知程度、职业认同和离职意愿等进行描述性分析[n(%)],采用有序多分类Logistic回归模型分析调查对象的人口学特征、一体化管理认知情况与职业认同、离职意愿之间的关系。结果一体化管理政策对乡村医生职业认同和留职意愿有促进作用,认同一体化管理以及纳入管理的乡医,对其职业认同感更强、离职意愿更低;存在的问题包括:对一体化政策“很了解”的人员仅占比26.8%,完全认同一体化的乡医比例仅为37.2%;乡村医生队伍中仅有5.9%的具有执业医师资格,高、中专学历占比62.8%;认为社会尊重乡村医生的比例仅占41.4%;部分高学历高执业等级的人员离职意愿较强。结论应进一步推动一体化政策保障落实,加强政策宣贯力度,从提高收入、优化职业环境、明确乡医身份,加强社会引导等层面提升乡村医生执业认同感;同时以丰富业务培训手段、强化执业教育、提升高学历高水平乡村医生执业待遇的角度,维护乡村医生队伍的稳定性。
Objective To sort out the problems of rural doctors by discussing the role of integrated management of health services in towns and villages in promoting the professional identity and turnover intention of rural doctors, and to provide theoretical support for the construction of a stable and high-quality team of village doctors. Methods A survey was conducted among 2652 rural doctors from ten agricultural regions of Tianjin. The descriptive analysis was made of the demographic characteristics, cognition of integrated management, professional identity and turnover intention, and the ordinal multinomial Logistic regression was adopted to analyze the demographic characteristics of respondents and the relationship between the cognition of integrated management and professional identity as well as turnover intention. Results Policies for integrated management promoted rural doctors’ professional identity and willingness to stay on the job. Rural doctors who agreed with integrated management and were included in the management had a stronger sense of professional identity and less willingness to leave their jobs. The existing problems included as follows: only 26.8% of the respondents had a good understanding of the policy for integrated management, and only 37.2% of the rural doctors totally agreed with integrated management;only 5.9% of the rural doctors had the qualification of practicing doctors, and 62.8% of them had the diploma of high technical secondary school. Only 41.4% of the respondents thought that the society respected rural doctors. Some of the personnel with higher educational background and higher practice level had stronger intention to quit. Conclusions It is necessary to further promote the guarantee of policies for integrated management, strengthen the publicity and implementation of policies, improve the professional identity of rural doctors from the aspects of increasing income and optimizing occupational environment, clarifying identity and strengthening social guidance. Meanwhile, the stabil
作者
龚超
骆达
张昱
薄云鹊
GONG Chao;LUO Da;ZHANG Yu;BO Yunque(Tianjin Health Development Research Center,Tianjin 300121,China;Tianjin Health Commission,Tianjin 300050,China)
出处
《中国农村卫生事业管理》
2020年第10期724-730,共7页
Chinese Rural Health Service Administration
基金
天津市北辰区科技计划项目立项(2018-SHGY-05)。
关键词
乡村医生
职业认同
离职意愿
影响机制
Rural doctor
Professional identity
Turnover intention
Influencing mechanism
