Health system reforms, violence against doctors and job satisfaction in the medical profession: a cross-sectional survey in Zhejiang Province, Eastern China.
Health system reforms, violence against doctors and job satisfaction in the medical profession: a cross-sectional survey in Zhejiang Province, Eastern China.
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DOI：
10.1136/bmjopen-2014-006431
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发表时间：
2014-12-31
期刊：
影响因子：
2.9
通讯作者：
Hesketh T
中科院分区：
文献类型：
--
作者：
Wu D;Wang Y;Lam KF;Hesketh T
探讨在我国医疗体制改革和医患关系恶化的背景下，影响医生工作满意度和士气的因素。采用自我完成问卷进行横断面调查。该调查于2012年3月至5月在中国浙江省的省、县和基层医疗机构的医生中进行。该问卷由202名医生完成。工作满意度低的主要因素是收入低和工作时间长。省级医生最不满意，基层医生最不满意。3%的高级医院医生和27%的初级保健医生对工资感到满意。只有7%的高级医院对工作时间感到满意，而初级保健的这一比例为43%。不到10%的高层对带薪休假时间（3%）和带薪病假（5%）感到满意，而初级保健的这一比例分别为38%和41%。总体而言，87%的人报告说，病人更有可能起诉，病人对医生的暴力行为正在增加。只有4.5%的人希望他们的孩子成为医生。在125名提供原因的人中，34%的人说工资低，17%的人说这是一个高风险的职业，9%的人表示担心个人不安全感或病人暴力。医生的工作满意度总体较低。招聘和留住医生已成为中国卫生系统面临的主要挑战。必须采取措施解决这一问题，以确保今后招聘和留住医生。这些措施必须首先包括减少医生的工作量，特别是在省级医院，部分通过激励适当利用初级保健，增加医生的工资和采取更有效的措施解决病人对医生的暴力行为。
To explore the factors influencing doctors’ job satisfaction and morale in China, in the context of the ongoing health system reforms and the deteriorating doctor–patient relationship. Cross-sectional survey using self-completion questionnaires. The survey was conducted from March to May 2012 among doctors at the provincial, county and primary care levels in Zhejiang Province, China. The questionnaire was completed by 202 doctors. Factors which contributed most to low job satisfaction were low income and long working hours. Provincial level doctors were most dissatisfied while primary care doctors were the least dissatisfied. Three per cent of doctors at high-level hospitals and 27% of those in primary care were satisfied with the salary. Only 7% at high-level hospitals were satisfied with the work hours, compared to 43% in primary care. Less than 10% at high levels were satisfied with the amount of paid vacation time (3%) and paid sick leave (5%), compared with 38% and 41%, respectively, in primary care. Overall, 87% reported that patients were more likely to sue and that patient violence against doctors was increasing. Only 4.5% wanted their children to be doctors. Of those 125 who provided a reason, 34% said poor pay, 17% said it was a high-risk profession, and 9% expressed concerns about personal insecurity or patient violence. Doctors have low job satisfaction overall. Recruitment and retention of doctors have become major challenges for the Chinese health system. Measures must be taken to address this, in order to ensure recruitment and retention of doctors in the future. These measures must first include reduction of doctors’ workload, especially at provincial hospitals, partly through incentivisation of appropriate utilisation of primary care, increase in doctors’ salary and more effective measures to tackle patient violence against doctors.
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