一个混合方法研究医生对绩效报酬的看法:对专业性,道德和工作与生活平衡的影响
Mustafa Volkan Kavas1, Hasan Tut2, Gamze Senyurek3
1Department of History of Medicine and Ethics, Izmir University of Economics, Faculty of Medicine, Sakarya Cad. No:156, 35330, Izmir, Balçova, Turkey. volkan.kavas@ieu.edu.tr.
BMC health services research
|January 14, 2025
概括
土耳其的绩效支付 (P4P) 制度导致医生疏远,对他们的职业生活,福祉和道德行为产生了负面影响. 这项研究揭示了P4P下医生的工作条件恶化和绝望感.
科学领域:
- 医疗保健管理的管理
- 医学社会学 医学社会学
- 专业道德 职业道德 专业道德
背景情况:
- 土耳其医疗保健部门于2004年实施了绩效支付 (P4P) 系统.
- 虽然P4P的目的是提高动机和患者满意度,但P4P引起了医疗保健专业人员对工作条件和质量结果的担忧.
研究的目的:
- 在P4P下调查医生对当前工作条件的看法.
- 检查P4P对医生作为道德代理人的地位及其专业态度的影响.
- 了解P4P对医生的专业,社会,私人和未来生活的感知影响.
主要方法:
- 定性阶段:由20名医生组成的3个重点小组,随后进行主题分析.
- 定量阶段:由定性发现开发的调查,分发给2136名医生.
- 使用斯皮尔曼相关性,探索性因子分析 (EFA) 和克鲁斯卡尔-瓦利斯测试对1378个有效答案的统计分析.
主要成果:
- 主题分析确定医生疏远是关键结果,影响工作和个人关系,工作条件和医疗保健质量.
- 疏远的表现包括心理痛苦,负面的未来前景,和妥协的道德选择权.
- EFA揭示了5个因素的结构:疏远,对生活质量的不利影响,有利的后果,职业声誉下降和不利的后果.
结论:
- 在土耳其P4P系统下的医生经历了与他们的职业,患者和自我疏远的增加.
- 工作条件恶化,动机下降和绝望感是医生经历的特征.
- P4P阻碍了医生作为符合专业价值观的道德代理人的能力.
关键词:
异化 异化 异化异化是一种疏离.工作动机的工作动机.工作满意度的工作满意度活着的经验,生活的经验.市场化 市场化道德主体 道德主体在P4P中,P4P是P4P绩效支付方式 (Pay-for-performance) 是一种支付方式.专业主义 专业主义土耳其 土耳其 土耳其 土耳其 土耳其 土耳其 土耳其 土耳其 土耳其意想不到的后果 意外的后果更多相关视频
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