公立医院医务人员工作满意度影响因素与治理机制
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摘要
针对当前医务人员工作满意度偏低、医患矛盾突出的社会现状,现有医务人员工作满意度研究缺失考察患者对医务人员的理性尊重、认可、信任,现行社会医疗体制、公共舆论环境等内容及条目设计,也缺乏将医务人员满意度测评与多元利益相关主体协同治理体系结合起来等理论与现实问题,本文在大量文献研究基础上,界定了治理视角下公立医院医务人员工作满意度概念;提出了"工作本身、组织管理、工作条件、工作回报、人际关系"五要素测评的内在维度;厘清了政府—医患—社会层面参与公立医院治理的主要利益相关主体以及各自职能、权利与社会医疗责任,探寻了影响医务人员工作满意度的外在治理因素;构建了医务人员工作满意度概念及多元协同治理结构逻辑模型,分析了各主体之间及其对医务人员工作满意度的作用机制;针对性提出了治理机制框架及思考,供学界争鸣与讨论。
In view of the current social status of medical staff with low job satisfaction and prominent contradictions between doctors and patients, the existing medical staff's job satisfaction researchfails to examine the rational respect, recognitionand trust of patients for medical staff,the current social health care system, public opinion,and other content of the current environment. There is also a lack of examining theoretical and practical issues such as the combination of the evaluation of medical staff satisfaction with the multi-stakeholder collaborative governance system.In this paper, the concept of medical staff job satisfaction from the perspective of governance is defined; the 5 internal dimensional factors ofmedical staff job satisfaction, namely work itself, organization management, working conditions, job return, and interpersonal relationship,are defined and summed up;the main stakeholders and their respective functions, rights and social medical responsibilities of government-doctor-patient participation in public hospital governance are clarified; the external governance factors that affect medical staff job satisfaction are explored; and finally the concept of medical staff job satisfaction and management logic model is constructed, and the mechanism of medical staffjobsatisfaction is analyzed. In addition, this paper puts forward the framework of governance mechanism and thinking.
In view of the current social status of medical staff with low job satisfaction and prominent contradictions between doctors and patients, the existing medical staff's job satisfaction researchfails to examine the rational respect, recognitionand trust of patients for medical staff,the current social health care system, public opinion,and other content of the current environment. There is also a lack of examining theoretical and practical issues such as the combination of the evaluation of medical staff satisfaction with the multi-stakeholder collaborative governance system.In this paper, the concept of medical staff job satisfaction from the perspective of governance is defined; the 5 internal dimensional factors ofmedical staff job satisfaction, namely work itself, organization management, working conditions, job return, and interpersonal relationship,are defined and summed up;the main stakeholders and their respective functions, rights and social medical responsibilities of government-doctor-patient participation in public hospital governance are clarified; the external governance factors that affect medical staff job satisfaction are explored; and finally the concept of medical staff job satisfaction and management logic model is constructed, and the mechanism of medical staffjobsatisfaction is analyzed. In addition, this paper puts forward the framework of governance mechanism and thinking.
引文
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[12] Hoppock. Job satisfaction[M]. New York:Harper&Brothers Publishers, 1935.
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[14] Ommen 0, Driller E, Kohler T, et al. The Relationship between Social Capital in Hospitals and Physician Job Satisfaction[J]. Bmc Health Services Research, 2009, 9(5):1-9.
[15] Danielle S, Sylvia M K, Joseph M, et al. U. S. Physician Satisfaction:A Systematic Review[J]. Journal of Hospital Medicine, 2009, 4(9):560-568.
[16]张宜民,尹文强,孙葵,等.公立医院医生工作满意度实证分析[J].中华医院管理杂志,2008, 24(7):459-462.
[17]王文星,马利,徐雅.医务人员工作满意度调查研究综述[J].医学与哲学,2014, 35(4):34-35.
[18]汪慧,钱宇,王小合,等.医务人员工作满意度测评量表的研制及验证研究[J].中国医院管理,2017, 37(3):14-17.
[2]王市敏.医务人员工作满意度对患者满意度的传导作用研究[J].医学与哲学,2013, 34(9):53-55.
[3]何文炯,杨一心.医疗保障治理与健康中国建设[J].公共管理学报,2017, 14(2):132-138.
[4]张文娟,郝艳华,吴群红,等.我国医患关系紧张的原因及对策[J].医学与社会,2014, 27(4):44-46.
[5]钱宇,王小合,谷雨,等.基于有限理性理论的患者满意度研究策略及框架构建.中国医院管理,2016, 36(2):40-42.
[6]冯夕秋.安徽省县级公立医院改革医务人员满意度调查分析[D].安徽医科大学,2014.
[7]李瑞,王小合,赵红,等.医疗卫生领域社会治理理论研究及应用概述[J].中国医院管理,2010, 30(10):1-3.
[8]王虎峰.用公共治理的理念推进医改[J].中国卫生,2014(9):29.
[9]钱宇,王小合,郑国管,等.医患满意度测评研究进展、问题及治理思考[J].中国医院管理,2017, 37(3):11-13.
[10]吴建平,胡涛.员工满意度:概念界定与影响因素分析——兼论当前员工满意度研究中的两个逻辑问题[J].中共福建省委党校学报,2011(7):84-88.
[11] Boquiren V M, Hack T F, Beaver K, et al. What do measures of patient satisfaction with the doctor tell us?[J].Patient Education&Counseling, 2015, 98(12):1465-1473.
[12] Hoppock. Job satisfaction[M]. New York:Harper&Brothers Publishers, 1935.
[13] Vroom V H. Work and motivation[J]. Industrial Organization Theory&Practice, 1964(2):2-33.
[14] Ommen 0, Driller E, Kohler T, et al. The Relationship between Social Capital in Hospitals and Physician Job Satisfaction[J]. Bmc Health Services Research, 2009, 9(5):1-9.
[15] Danielle S, Sylvia M K, Joseph M, et al. U. S. Physician Satisfaction:A Systematic Review[J]. Journal of Hospital Medicine, 2009, 4(9):560-568.
[16]张宜民,尹文强,孙葵,等.公立医院医生工作满意度实证分析[J].中华医院管理杂志,2008, 24(7):459-462.
[17]王文星,马利,徐雅.医务人员工作满意度调查研究综述[J].医学与哲学,2014, 35(4):34-35.
[18]汪慧,钱宇,王小合,等.医务人员工作满意度测评量表的研制及验证研究[J].中国医院管理,2017, 37(3):14-17.