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首页> 外文期刊>Frontiers in Public Health >The Awareness and Attitude of Contracted Service Among General Medical Practitioners in Community Health Service Centers in Urban China: A Cross-Sectional Study
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The Awareness and Attitude of Contracted Service Among General Medical Practitioners in Community Health Service Centers in Urban China: A Cross-Sectional Study

机译：城市社区卫生服务中心的一般医学师契约服务的认识与态度：横断面研究

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摘要

This study aims to explore the attitude, willingness, and satisfaction with contracted service (CS) among staff in community health service (CHS) centers in urban China and to explore the associated factors of satisfaction with CS. From August 2016 to July 2017, five CHS centers in three provinces of China were selected. Setting-level information was collected by official document review; and personal information on demographic characteristics, awareness, willingness, and attitude of CS among staff was collected by questionnaire survey. Univariate and multivariable logistic regression models were fitted to explore the associated factors of satisfaction with CS. Multiple correspondence analysis (MCA) was used to visually demonstrate the correlations among category data related with satisfaction with CS. The CS signing rates were 30.78, 12.72, 22.20, 14.32, and 21.19% in the five CHS centers. A total of 286 staff included family doctors (40.91%), nurses (31.12%), and others (27.97%) completed the survey. For the sense of self-worth, 86.01% (246/286) participants hold a positive attitude. The predominant barrier of CS signing was caused by the work pressure due to CS performance assessment (48.60%, 139/286). About 30% of family doctors and nurses reported a heavy work pressure, and more than 30% of doctors had great feeling of fatigue. Notably, 51.69% family doctors would like to change their job in the future. Compared with other staff, family doctors were more likely to be unsatisfied with CS (OR: 2.793, 95% CI: 1.155–6.754, p = 0.022). Participants in Sichuan province have lower satisfaction than other places. The MCA yielded similar factors consistent with multivariable results of clustering with different levels of CS satisfaction. Our study revealed that the CS coverage and satisfaction among staff from the primary healthcare system varied geographically and are associated with professional field, workload, and pressure. Measures that aim to promote the stability of primary care human resource should be considered in the future.
机译：本研究旨在探讨与城市城市社区卫生服务（CHS）中心的工作人员中的合同服务（CS）的态度，意愿和满足感，并探讨与CS满意的相关因素。从2016年8月至2017年7月，选择了三个省的五个CHS中心。官方文件审查收集了设定级信息;关于员工调查调查收集了关于工作人员中CS的人口特征，意识，意愿和态度的个人信息。单变量和多变量的逻辑回归模型拟探索与CS满意的相关因素。多个对应分析（MCA）用于视觉上展示与CS满意相关的类别数据之间的相关性。 CS签约率为30.78,12.72,22.20,14.32，21.19％，21.19％。共有286名工作人员包括家庭医生（40.91％），护士（31.12％），其他人（27.97％）已完成调查。为自我价值感，86.01％（246/286）参与者持有积极的态度。 CS签名的主要屏障是由于CS性能评估而导致的工作压力（48.60％，139/286）。大约30％的家庭医生和护士报告了沉重的工作压力，超过30％的医生有很大的疲劳感。值得注意的是，51.69％的家庭医生想在将来改变他们的工作。与其他工作人员相比，家庭医生更有可能与CS不满意（或：2.793,95％CI：1.155-6.754，P = 0.022）。四川省的参与者比其他地方的满意度较低。 MCA产生了类似的因素，这与多变量的聚类结果一致，不同水平的CS满意度。我们的研究表明，初级医疗系统的工作人员之间的CS覆盖率和满意度在地理上变化，与专业领域，工作量和压力相关。旨在促进初级保健人力资源稳定的措施应在未来考虑。

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