基于离散选择实验的护理本科生对基层卫生工作偏好分析

发布时间：2018-12-20 07:44

【摘要】：背景分级诊疗制度是我国新医改"十三五"规划的五项重点任务之首,而基层卫生机构人员素质不高、医疗水平低下是制约分级诊疗制度有效落实的主要障碍,如何吸引和留住高素质的医护人员是推行分级诊疗制度过程中需要解决的重要问题。目的了解并分析护理本科生对基层卫生工作的偏好,提出相应的干预策略。方法基于离散选择实验,选取2017年3月在唐山市某三甲医院实习的符合纳入标准的护理本科生164人进行问卷调查。采用混合Logistic回归分析进行统计分析。结果共发放问卷164份,经逻辑纠错发现无效应答问卷11份,有效问卷153份,有效应答率为93.3%。护理本科生对基层卫生工作属性的偏好程度从大到小依次为月收入、子女就读条件、人员编制、工作地点、工作条件、职称晋升时间和系统培训机会(P0.05)。当工作属性为:工作月收入为2 000元、在农村、无人员编制、子女就读条件较差、职称晋升时间为5年、无系统培训机会、设备和设施不完善,护理本科生中不愿意到基层卫生工作的人员比例为75%;其中假如子女就读条件得到改善,不愿意到基层卫生工作的人员比例将下降至38%。结论离散选择实验是适合分析护理本科生工作偏好的研究方法。影响护理本科生基层卫生工作意愿的因素既包括经济因素,也包括非经济因素。应针对护理本科生制定有效的政策干预包。
[Abstract]:Background the classified diagnosis and treatment system is the first of the five key tasks of the 13th Five-Year Plan of the New Medical Reform in China, but the quality of the primary health personnel is not high, and the low medical level is the main obstacle to the effective implementation of the graded diagnosis and treatment system. How to attract and retain high-quality medical personnel is an important problem to be solved in the process of carrying out the classified diagnosis and treatment system. Objective to understand and analyze the preference of undergraduate nursing students to primary health work and put forward corresponding intervention strategies. Methods based on the discrete selection experiment, 164 nursing undergraduates who met the inclusion criteria in March 2017 in a third class hospital in Tangshan were investigated by questionnaire. Mixed Logistic regression analysis was used for statistical analysis. Results 164 questionnaires were sent out, 11 of which were found to be invalid and 153 were valid. The effective response rate was 93.33. The degree of preference of undergraduate nursing students to the basic health work attributes from big to small is monthly income, children's study condition, staffing, working place, working condition, promotion time and systematic training opportunity (P0.05). When the job attribute is as follows: the monthly income of work is 2,000 yuan, in rural areas, there is no personnel, the children are poor in study conditions, the promotion time of professional title is 5 years, there is no systematic training opportunity, and the equipment and facilities are not perfect. The proportion of nursing undergraduates who did not want to work in primary health care was 75. If the children's schooling conditions are improved, the proportion of people who do not want to work in primary health care will fall to 38. Conclusion the discrete selection experiment is suitable for analyzing the work preference of nursing undergraduates. The factors influencing the willingness of primary health care of undergraduate nursing students include both economic and non-economic factors. The effective policy intervention package should be made for nursing undergraduates.
【作者单位】：唐山市工人医院护理部;华北理工大学管理学院;
【基金】：河北省社会科学基金项目(HB17GL074)
【分类号】：G647.38;R47-4

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