The role of task shifting in reforming the working styles of pediatricians in Japan: A questionnaire survey.
The role of task shifting in reforming the working styles of pediatricians in Japan: A questionnaire survey.
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DOI：
10.1097/md.0000000000030167
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发表时间：
2022-09-02
期刊：
影响因子：
1.6
通讯作者：
Ishikawa, Masatoshi
中科院分区：
文献类型：
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作者：
Ishikawa, Masatoshi
为了缩短在日本经常过度工作的儿科医生的工作时间，必须确定任务转移的推荐任务，并研究促进任务转移对医疗质量和工作时间的影响。还必须考虑儿科的特点。对在日本各地医院工作的儿科医生进行了问卷调查。以不建议工作场所任务转移的儿科医生为被解释变量，以儿科医生的属性（性别、年龄、主要工作场所、儿科医生人数、儿科医疗管理费）为被解释变量，进行多元Logistic回归分析。详细介绍了建议任务转移的任务以及建议任务转移对医疗服务质量和工作时间的影响。问卷被发送到全国848家医院，计算儿科住院医疗管理费用，并收到了416家医院1539名儿科医生的回复（回复率：49%）。作为231名（15%）认为工作转移在其工作地点根本没有进展的医生的特征，在国立和公立大学医院、私立大学医院、私立医院和儿科住院医疗护理管理费1医院工作的男性中发现了显着的正相关。总体上不推荐任务转移，因为大多数儿科医生标记为“转移”的任务项目仅限于“用药说明”和“抗生素静脉注射等”。超过一半的受访者（60%，共921名医生）表示，在推进任务转移后，医疗质量略有或显著改善。对于调查项目中询问可通过任务转移缩短的工作时数，最常见的答复是“1至2小时”。根据参与者所在科室的特点确定适合任务转移的任务。结果表明，任务转移是不推荐在大学医院，促进任务转移可以提高医疗质量和减少儿科医生的工作时间。
We aimed to shorten the working hours of pediatricians who are regularly experiencing overwork in Japan, recommended tasks for task shifting must be identified, and the impact of promoting task shifting on both the quality of medical care and working hours must be examined. Characteristics of the pediatric department must also be considered. A questionnaire survey was conducted with pediatricians working in hospitals across Japan. A multiple logistic regression analysis was performed with pediatricians who did not recommend task shifting in the workplace as the explained variable and the attributes of the responding pediatricians (gender, age, primary workplace, number of pediatricians, pediatric medical management fee) as the explanatory variables. Details about the tasks recommended for task shifting and the impact of recommending task shifting on the quality of medical care and working hours were described. Questionnaires were sent nationwide to 848 hospitals that calculated pediatric inpatient medical management fees and received responses from 1539 pediatricians in 416 hospitals (response rate: 49%). As a characteristic of 231 (15%) doctors who thought that the task shift had not progressed at all at their place of employment, significant positive associations were found in men, working at national and public university hospitals, private university hospitals, and private hospitals and pediatric inpatient medical care management fee 1 hospitals. Task shifting was not recommended overall, as the task items that a majority of pediatricians marked as “transferred” were limited to “medication instructions” and “intravenous injection of antibiotics, etc” More than half of the respondents (60%, a total of 921 doctors) reported that the quality of medical care improved slightly or significantly when task shifting was promoted. The most frequent response to survey items querying the number of work hours that could be shortened through task shifting was “1 to 2 hours.” The tasks suitable for task shifting were identified based on the characteristics of participants’ pediatric departments. Results suggest that task shifting was not recommended in university hospitals and that promotion of task shifting could improve the quality of medical care and reduce the working hours of pediatricians.