上海市全科医学规范化培训学员选择社区卫生中心就业的影响因素分析
Factors related to choice of community health service centers in standardized training general practitioners in Shanghai
目的 了解上海市全科住院医师规范化培训学员选择社区卫生服务中心就业的影响因素.方法 采用自行设计的调查表对上海市2013年住院医师规范化培训全科医学科(含中医全科)结业并在上海市社区卫生服务中心就业的152名学员进行横断面调查.结果 152名学员中,113人(74.3%)表示最重视薪资水平,58人(38.2%)工作后前3年期待年薪大于12万元.学员更倾向选择“市中心”(61人,40.1%)和“离家近”(58人,38.2%)的社区卫生服务中心就业,主要因为“交通的便利性”(91人,59.9%).考虑到个人发展,综合医疗水平高(78人,51.3%)、辖区面积大服务人口数多(77人,50.0%)的社区卫生服务中心更具有吸引力.学员关注较多的其他因素是“全国示范性社区卫生服务中心”(87人,57.2%)和“进入上海优秀青年医师培养计划人数多的社区卫生服务中心”(77人,51.7%).户籍是影响选择社区卫生服务中心的最主要因素,相对于非沪籍学员,沪籍学员较多考虑社区地理位置(61.8%比34.2%),更倾向于选择离家近的社区卫生服务中心(55.3%比21.1%);非沪籍学员更重视编制问题(51.3%比28.9%).西医类全科医师期待年薪较中医类高(x2=13.648,P<0.05),男性较女性高(x2=7.799,P<0.05).结论 全科住院医师规范化培训学员选择社区卫生服务中心就业时最重视薪资水平,倾向选择位于市中心、实力强、规模大的社区卫生服务中心,户籍、全科医师类别、性别是影响学员选择的因素.
更多Objective To investigate the factors related to choice of community health service centers (CHSCs) in standardized training general practitioners (GPs) in Shanghai.Methods Totally 152 GPs,(including those of Traditional Chinese Medicine) who completed the residency training in 2013 and signed employment contract with community in Shanghai were surveyed with a self-designed questionnaire.Results Among all the participants,113 (74.3%) attached the greatest importance to the salary level when choosing CHSC,58 (38.2%) expected annual salary more than 120 000 Yuan during the first 3 years.GPs tended to work in the city center(40.1%) or CHSCs near to their home(38.2%),mainly because of the job commuting (59.9%).Considering career development,the CHSCs with high level comprehensive service (51.3%) and with large population (5.0%) were more attractive.GPs paid more attention to the "national demonstration community" (57.2%) and CHSCs with member of " Shanghai outstanding young physician training program"(51.7%).In this survey,household register was the main influencing factor for choosing CHSCs,Shanghai natives paid more attention to the location of the community than those not Shanghai natives (61.8% vs.34.2%),more inclined to CHSCs that close to their house (55.3% vs.21.1%),non-Shanghai natives preferred authorized strength (51.3% vs.28.9%).GPs of Western medicine expected higher salary than GPs of TCM (x2 =13.648,P < 0.05),Males expected higher salary than females (x2 =7.799,P < 0.05),Conclusions GPs pay the most attention on salaries and tend to work in the city central area,prefer CHSC with high level comprehensive service and large served population.The main factor influencing GPs to chose CHSCs is the household register,the category of Gps and gender.
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