A Study On Present Situation And Promotion Countermeasure Of Physician's Practice Environment In The Third-class Hospital In Shanxi

Objective:Understand the present situation of the doctor's practice environment systematically and influence factors in the Third-Class Hospital in Shanxi Province from the five dimensions of working environment,personal value manifestation,professional satisfaction,social environment,and institutional environment,to provide policy basis for hospital managers.Methods:1.Literature research method: Through collecting and reading a large amount of literature and datas,learn about the current research results on the practice environment of physicians,study previous research ideas and methods,comb the research theories of the practice environment at home and abroad,and master the investigation metheds of the medical practice environment.2.Questionnaire survey method: Based on the survey scale,comprehensively considering the economic development situation,comprehensive strength and the number of doctors in each hospital,a stratified random sampling method was be used to select physicians as dsurvey object from six tertiary hospital in 11 respondents in Shanxi Province.3.Statistical analysis method: Mean value ± standard deviation is used for continuous variables,count data is expressed by rate and composition ratio.In univariate analysis,there ie maining use t-tests,analysis of variance and pearson correlation analysis.For multivariate analysis,Logistic linear regression analysis was used.Results:1.A total of 900 questionnaires were distributed in this survey.There were 837 valid questionnaires and the effective recovery rate was 93%.The overall average score of the doctor's practice environment was(106.16 ± 18.16),with a highest score of 161 and a lowest score of 56,and with a full score of 180 points.2.The working environment,personal value manifestation and practice satisfaction in the practice environment of doctors scored are lower.Among them,"I think the currentpractice risk is relatively high" and "the average daily working time exceeds 8 hours" are(1.81 ± 0.72)points and(1.95 ± 0.96)points,"Compared with other public institution employees such as teachers and national civil servants,my income can reflect my own value scored(2.35 ± 1.03),"I hope my children will become medical workers in the future",and the score is(2.17 ± 1.15).3.The Physician's social environment and institutional environment scores higher,and their practice environment is better."Patients have great homage for me","Patients have great trust in me","My superior doctor or department director is very concerned about the construction of talent echelon",and "The cultural atmosphere of knowledge and skills innovation in my hospital" The scores are(3.61 ± 0.78),(3.73 ± 0.80),(3.58 ± 1.12),and(3.48 ± 0.94)points,and there is possibility to improve.4.In univariate analysis,the difference of different genders(t =-2.778,P = 0.006),age(t = 2.976,P = 0.019),education level(t = 9.337,P <0.001),technical title(t = 5.567,P <0.001),the presence or absence of personnel file(t =-2.068,P = 0.039),different monthly income(t = 2.753,P = 0.027),and the number of years of service(t = 3.408,P =0.009)of the doctor's practice environment score was statistically significant(P <0.05).5.The result of multivariate analysis shows that the four variables of gender,education leval,technical title,and monthly income may be the influencing factors of the physician's practice environment.Physicians such as higher education qualifications,higher professional titles,and lower monthly income should be the main targets for improving the practice environment.Conclusion:1.The working environment,personal value manifestation and professional satisfaction of the surveyed physician group are relatively scored lower,and the social and institutional environment is relatively scored higher,which prompts that hospital managers and related management departments should focus on these factors to improve the practice environment of doctors.2.The four variables of gender,education leval,technical title,and monthly income are the main factors affecting the physician's practice environment.It is suggested that physicians of male,higher education qualifications,senior professional titles,and low monthly income is the focus for improving the practice environment.It should be targeted in taking countermeasures to manage hospital.