初级保健和专科医生职业满意度的变化,1997-2001年
Bruce E Landon1, James Reschovsky, David Blumenthal
1Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, Mass 02115, USA. landon@hcp.med.harvard.edu
JAMA
|January 22, 2003
概括
医生职业满意度在1997-2001年间略有下降,大多数变化与减少的临床自主权和增加的工作量有关,而不是收入或管理护理.
科学领域:
- 医学实践的动态 医学实践的动态
- 医生职业趋势 医生职业趋势
- 医疗服务研究 医疗服务研究
背景情况:
- 在过去的十年中,医疗领域经历了重大变革.
- 在这些变化中,医生对工作的满意度似乎在下降.
研究的目的:
- 分析大型全国医生队伍中职业满意度的变化.
- 调查影响医生满意度变化的实践和市场因素.
主要方法:
- 利用了社区追踪研究 (CTS) 医生调查的三轮数据 (1996-2001).
- 包括初级保健和专科医生每周至少工作20小时的病人护理.
- 评估了总体职业满意度和特定职位的不满率的变化.
主要成果:
- 从1997年到2001年,医生满意度略有下降,主要是在1997年至1999年之间.
- 在60个不同的美国地点观察到满意度水平的显著差异.
- 临床自主性的减少,工作时间的延长以及患者护理协调方面的挑战与满意度的降低密切相关.
结论:
- 整体医生满意度保持相对稳定,有显著的特定地点变化.
- 影响满意度的最重要因素是对医生的自主权和护理质量的威胁.
- 管理护理暴露的变化与医生满意度的变化有很弱的相关性.
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