CAJ | 학술논문

目的：了解基本药物制度背景下乡村医生的流失意图，并探讨其影响因素。方法于2012年8—12月，采用多阶段分层随机抽样法，以山东省为样本地区抽取乡村医生621名。采用课题组自行设计的问卷对乡村医生进行调查，内容包括人口学信息、职业信息及流失意图信息3部分。剔除不合格问卷14份，最终确定有效问卷607份。采用 Logistic 回归分析探讨乡村医生流失意图的影响因素，结合重要性象限推导模型分析乡村医生流失意图各影响因素的重要程度。结果有流失意图的乡村医生数为386名（占63.6％）。单因素 Logistic 回归分析显示，不同年龄、工作年限、技术职称、执业资格、工资水平满意度、工作环境满意度、人际关系满意度、个人能力和潜力发挥满意度、发展前景满意度及管理水平满意度乡村医生的流失意图比较，差异有统计学意义（P ＜0.05）。多因素 Logistic 回归分析显示，工作环境满意度、人际关系满意度、个人能力和潜力发挥满意度、发展前景满意度对乡村医生流失意图的影响有统计学意义（P ＜0.05）。重要性象限推导模型分析显示，发展前景满意度为重要程度较低、可暂时搁置因素；人际关系满意度为重要程度较高、需要优先解决因素；个人能力和潜力发挥满意度、工作环境满意度为重要程度较低，但满意度得分较高的因素。结论基本药物制度实施后，乡村医生的流失意图较高，工作环境满意度、人际关系满意度、个人能力和潜力发挥满意度、发展前景满意度是其流失意图的影响因素。其中，人际关系满意度为重要程度较高，需要优先解决的因素。
목적：료해기본약물제도배경하향촌의생적류실의도，병탐토기영향인소。방법우2012년8—12월，채용다계단분층수궤추양법，이산동성위양본지구추취향촌의생621명。채용과제조자행설계적문권대향촌의생진행조사，내용포괄인구학신식、직업신식급류실의도신식3부분。척제불합격문권14빈，최종학정유효문권607빈。채용 Logistic 회귀분석탐토향촌의생류실의도적영향인소，결합중요성상한추도모형분석향촌의생류실의도각영향인소적중요정도。결과유류실의도적향촌의생수위386명（점63.6％）。단인소 Logistic 회귀분석현시，불동년령、공작년한、기술직칭、집업자격、공자수평만의도、공작배경만의도、인제관계만의도、개인능력화잠력발휘만의도、발전전경만의도급관리수평만의도향촌의생적류실의도비교，차이유통계학의의（P ＜0.05）。다인소 Logistic 회귀분석현시，공작배경만의도、인제관계만의도、개인능력화잠력발휘만의도、발전전경만의도대향촌의생류실의도적영향유통계학의의（P ＜0.05）。중요성상한추도모형분석현시，발전전경만의도위중요정도교저、가잠시각치인소；인제관계만의도위중요정도교고、수요우선해결인소；개인능력화잠력발휘만의도、공작배경만의도위중요정도교저，단만의도득분교고적인소。결론기본약물제도실시후，향촌의생적류실의도교고，공작배경만의도、인제관계만의도、개인능력화잠력발휘만의도、발전전경만의도시기류실의도적영향인소。기중，인제관계만의도위중요정도교고，수요우선해결적인소。
Objective To investigate the turnover intention of rural doctors under essential medicine system and the influencing factors. Methods We selected Shandong Province as the sample area and enrolled 621 rural doctors there using multistage stratified random sampling method from August to December,2012. A self - designed questionnaire was used to conduct survey on enrolled doctors. The survey included demographic information, professional information, and turnover intention. After the exclusion of 14 unqualified questionnaires,we at last acquired 607 effective questionnaires. Logistic regression analysis was conducted to investigate the influencing factors for turnover intention of rural doctors,and important quadrant model was adopted to explore the influence degree. Results There were 386 ( 63. 6% ) rural doctors who had turnover intention. Univariate logistic regression analysis showed that age,years of working,professional titles,practicing requirements and the satisfaction degrees with salary, working environment, interpersonal relation, personal capability and potential development,development prospect and management level had significant influence on the turnover intention of rural doctors(P< 0. 05). Multiple logistic regression analysis showed that the satisfaction degrees with working environment,interpersonal relation,personal capability,potential development and development prospect had significant influence on the turnover intention of rural doctors ( P < 0. 05 ) . Important quadrant model analysis showed the following results: satisfaction degree with development prospect has low influence degree,thus it can be overlooked;satisfaction degree with interpersonal relation has high influence degree,thus it needs to be solved first;sastification degrees with personal ability,potention development and working environment have low influence degree but have high score of satisfaction degree. Conclusion After the implementation of essential medicine system,the turnover intention of rural doctors is strong. The satisfaction degrees with working environment, interpersonal relation,personal capability,potential development and development prospect are influencing factors for turnover intention of rural doctors,among which satisfaction degree with interpersonal relation has high influence degree and needs to be solved first.