CAJ | 학술논문

目的：分析新医改前后公立医院医生工作状态及执业环境的变化。方法2007年和2011年分别调查医生1520人和1910人,利用构成比和双变量相关进行数据分析。结果两次调查相比,对工作表示满意者减少6.8%。认同“工作自主权”者减少21.1%,处于“疲劳”状态者增加5.1%；有“被患者信任感”者减少21.1%；对社会地位满意者减少9.1%,对媒体报道认同率上升12.3%。2007年与工作满意度相关最强的5个问题是“收入分配公平”“技术劳务价值体现”“收入付出相称”“职称评定公平”和“医改政策”(相关系数 r 分别为0.53、0.51、0.52、0.51、0.45,P 值均<0.01),2011年则为“患者信任”“医疗诉讼”“收入分配公平”“医改政策”和“纠纷处理”(相关系数 r 分别为0.50、0.50、0.50、0.49、0.48,P 值均<0.01)。“媒体报道”关注度上升最明显(相关系数 r 由0.04上升到0.45)。结论新医改鼓舞医生效果不明显。患者“高期望、低信任”倾向突出,医疗风险压力大,医生“疲劳高危”的工作状态没有改观。重塑医患信任、分散职业风险、改善执业环境是鼓舞医生的关键。
목적：분석신의개전후공립의원의생공작상태급집업배경적변화。방법2007년화2011년분별조사의생1520인화1910인,이용구성비화쌍변량상관진행수거분석。결과량차조사상비,대공작표시만의자감소6.8%。인동“공작자주권”자감소21.1%,처우“피로”상태자증가5.1%；유“피환자신임감”자 감 소21.1%；대사회지위만의자감소9.1%,대매체보도인동솔상승12.3%。2007년여공작만의도상관최강적5개문제시“수입분배공평”“기술노무개치체현”“수입부출상칭”“직칭평정공평”화“의개정책”(상관계수 r 분별위0.53、0.51、0.52、0.51、0.45,P 치균<0.01),2011년칙위“환자신임”“의료소송”“수입분배공평”“의개정책”화“규분처리”(상관계수 r 분 별 위0.50、0.50、0.50、0.49、0.48,P 치균<0.01)。“매체보도”관주도상승최명현(상관계수 r 유0.04상승도0.45)。결론신의개고무의생효과불명현。환자“고기망、저신임”경향돌출,의료풍험압력대,의생“피로고위”적공작상태몰유개관。중소의환신임、분산직업풍험、개선집업배경시고무의생적관건。
Objective To compare the work well-being among physicians between two surveys (2007 and 201 1 )performed in public hospital of Shandong province.Methods The constituent ratios and Pearson correlation coefficient of two surveys with 1 520 and 1 910 respondents were compared.Results The proportion of satisfied physicians decreased from 6.8% between the two surveys.Those approving"work autonomy" dropped 21.1%;those satisfied with their social standing dropped 9.1%,and those recognizing media coverage increased 12.3%.In year 2007,the top five issues most concerned with work satisfaction were"income equity","embodiment of professional value","balance between income and workload","equity of academic title appraisal",and"health reform policy" (r were 0.53,0.5 1,0.52, 0.5 1,and 0.45,with P average< 0.01 ).While in year 201 1,the top five issues most concerned with work satisfaction were "patient turst","medical lawsuit","income equity","health reform policy","dissension dealing"(r were 0.50,0.50,0.50,0.49,0.48 ).Attention to "medical reports" rising the most (r from 0.04 to 0.45).Conclusion There was little positive change on physicians'work well-being before and after new health reform while physicians are bearing "tiredness and high risk" under "high expectation and low trust".Rebuilding the patients'trust,dispersing risks of the medical profession and improving the practicing environment are the keys to motivating physicians.