| BackgroundAs the core resources of public hospitals,medical staff is the most critical factor to improve medical quality.General Secretary Xi Jinping pointed out that deepening the reform of public hospitals requires further stabilizing the construction of health personnel and realizing the goal of healthy China.However,due to the particularity of the medical industry,the current working status of medical staff is worrying,and the dimission situation is increasingly serious,which has aroused widespread concern from all walks of life.Remuneration,as an important factor for most employees to consider when choosing a job,is of great significance to mobilize the enthusiasm of personnel and stabilize the talent team.A reasonable salary level can not only motivate the initiative of medical staff,but also help build a harmonious doctor-patient relationship,which contributes to the long-term development of medical undertakings.Studies have shown that in addition to salary level,workload,organizational recognition and sense of belonging are also important factors affecting the dimission of medical staff.Therefore,this study proposed the concept of total reward to explore its impact on turnover intention,and took job satisfaction as an intermediary to construct the mechanism of the relationship between the three,so as to provide evidence-based basis for finding effective work incentive factors,improving the satisfaction of medical staff and alleviating the turnover problem of health talents.ObjectiveThe purpose of this study is to quantitatively analyze the status quo of overall compensation,job satisfaction and turnover intention of medical staff in public hospitals in Shandong Province,explore the path relationship between overall compensation,job satisfaction and turnover intention of medical staff in public hospitals,and reveal the mediating role of job satisfaction.It provides countermeasures and suggestions for public hospitals to reduce the dimission rate of medical staff and build a stable and efficient staff team.MethodsIn this study,a multi-stage stratified sampling method was used to select 17 hospitals in Shandong Province for investigation,with a total of 5413 medical staff surveyed.The survey included personal profile,total compensation Scale,Minnesota Job Satisfaction Scale and turnover intention.SPSS24.0 and Mplus8.3 software were used for data analysis,descriptive analysis,independent sample T test and Chi-square test were conducted for each research variable,and binary Logistic regression was used to further explore the impact of total compensation on turnover intention.The relationship among total compensation,job satisfaction and turnover intention was analyzed by Pearson correlation analysis.Bootstrap method was used to verify the mediating effect of job satisfaction on total compensation and turnover intention.Results(1)Basic information of respondents:Among the 5413 respondents,75.2%were female,32.9%were from municipal general hospitals,53.1%were nurses,17.8%held administrative positions,40.1%were intermediate titles,32.7%of respondents had experienced doctor-patient disputes in the past year,and 63.6%believed that hospitals did not provide them with adequate psychological counseling.(2)Status quo of overall compensation,job satisfaction and turnover intention:The overall compensation score of medical staff in Shandong province was 3.49,with the highest score of recognition perception 3.95,followed by salary and career development,and the lowest score of work-life balance 2.95.The average score of overall satisfaction of medical staff was 3.73,internal satisfaction was 3.79,and external satisfaction was 3.66.Among the respondents,1358 medical workers,or 25.1%,had intention to quit their jobs.(3)Influencing factors of turnover intention:compared with medical staff younger than 30 years old,the risk of turnover intention in 30-39 years old was reduced(OR=0.747);Medical staff on the side were more likely to leave than those on the regular staff(OR=1.816);Medical staff with more than 2 chronic diseases had higher turnover tendency than those without chronic diseases(OR=1.732);The risk that the hospital did not provide adequate psychological counseling was 1.334 times higher than that the hospital did not provide adequate psychological counseling.All dimensions of total compensation had a negative influence on turnover intention(P<0.05),and the degree of influence was as follows:work-life balance(β=-0.723)>salary and career development(β=-0.260)>recognition perception(β=-0.067).(4)Mediating effect analysis:Internal satisfaction has a mediating effect between salary and career development(OR=0.919,95%CI:0.8677-0.972),perceived recognition(OR=0.974,95%CI:0.9566-0.991)and work-life balance(OR=0.947,95%CI:0.910-0.982)and turnover intention,with a total effect of 0.567,0.858 and 0.168,respectively.When external satisfaction was used as an intermediary,the direct effects of salary and career development(OR=0.904,95%CI:0.7688-1.064)and perceived approval(OR=0.906,95%CI:0.816-1.007)on turnover intention were not statistically significant.The mediating effect of external satisfaction between salary and career development(OR=0.609,95%CI:0.541-0.681),perceived recognition(OR=0.945,95%CI:0.925-0.962)and work-life balance(OR=0.792,95%CI:0.747-0.836)and turnover intention was statistically significant.Conclusions and SuggestionsThe overall compensation perception of medical staff is at the average level,and the work-life balance problem is more prominent.The job satisfaction is above medium level,and the turnover tendency is high.Demographic characteristics and job characteristics have an impact on the overall remuneration,job satisfaction and turnover intention of medical staff.The overall remuneration of medical staff is positively correlated with job satisfaction,while the overall remuneration,job satisfaction and turnover intention are negatively correlated.Among them,work-life balance has the highest impact on turnover intention,followed by salary and career development,and perceived approval is the lowest.Job satisfaction has a mediating effect on total compensation and turnover intention.Based on the above conclusions,in order to reduce the turnover intention of medical staff,the following suggestions are proposed in this study:(1)To build a demand-oriented overall compensation system;(2)Pay attention to the balance between work and life and relieve work pressure;(3)Raise the salary level and establish a fair distribution mechanism;(4)Strengthen organizational recognition and incentive to create a good cultural environment;(5)Pay attention to respect and care for medical staff. |
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