摘要
目的:探究突发公共卫生事件期间乡村医生基本医疗服务量、职业认同感以及离职意愿情况的关系,为加强乡村医生队伍建设提供参考。方法:通过多阶段分层随机抽样于2020年9-12月调查湖北省7个县区的1022名乡村医生,采用单因素检验和二分类logistic回归分析基本医疗服务量对离职意愿情况的影响,及职业认同感在其中的调节效应。结果:职业认同感强、基本医疗服务量减少和有离职意愿的湖北省乡村医生分别占比49.9%、52.2%和18.0%。服务量减少显著增加离职意愿[β=-0.838,P<0.001,OR=2.31,95%CI=(1.445, 3.701)];职业认同感在基本医疗服务量对离职意愿的作用中起负向调节作用(β=-2.141,P<0.05)。结论:突发公共卫生事件期间乡村医生基本医疗服务量下降会导致其离职意愿情况增加,职业认同感在其中发挥调节作用。针对乡村医生职业保障不足的问题,建议优化补助与收入保障,并在应急管理政策制定过程中充分考虑对乡村人才队伍稳定性的影响。
Objective:To explore the relationship between the quantity of basic medical service,professional identity and turnover intention of village doctors in public health emergencies,providing a reference for strengthening the construction of the village doctor team.Methods:A multi-stage stratified random sampling was conducted from September to December 2020 among 1022 village doctors in seven counties of Hubei Province.Univariate tests and binary logistic regression analysis were used to examine the relationship between changes in the quantity of basic medical services,professional identity,and turnover intention.Results:The proportions of village doctors with a strong sense of professional identity,a decrease in the quantity of basic medical services,and an intent to leave were 49.9%,52.2%,and 18.0%,respectively.A significant increase in the intent to leave was observed with the decrease in service volume[β=-0.838,P<0.001,OR=2.31,95%CI=(1.445,3.701)];professional identity had a significant negative moderating effect(β=-2.141,P<0.05).Conclusion:A decrease in the quantity of basic medical services among village doctors during public health emergencies stimulates turnover intention,with professional identity playing a moderating role.In response to the insufficient professional security of village doctors,it is recommended to optimize subsidies and income security and fully consider the impact on the stability of village doctors when formulating emergency management policies.
作者
刘素薇
高红霞
陈迎春
陈诚
麻磊
郑佩瑶
胡西子
LIU Suwei(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,430030,China)
出处
《医学与社会》
北大核心
2025年第8期17-22,41,共7页
Medicine and Society
基金
教育部人文社科基金面上项目资助(“区域整合型”村级卫生机构和人力配置模式研究与模拟优化,21YJA630017)。
关键词
乡村医生
职业认同感
基本医疗服务
离职意愿
湖北
Village Doctor
Professional Identity
Basic Medical Service
Turnover Intention
Hubei
