乡镇卫生人员主动离职现状及影响因素分析

摘要

目的 了解乡镇卫生人员主动离职现状及影响因素,并提出相关对策建议.方法 采用典型抽样的方法,从我国东部、中部和西部选取共3省6县86个乡镇卫生院,对其2012—2016年间主动离职人员情况进行调查,同时从每个县随机抽取2个乡镇卫生院,采用基于Price-Mueller模型的自制问卷对当日在岗的251名卫生人员的离职影响因素进行调查.结果 2012—2016年被调查乡镇卫生院共流出1432人,其中主动离职占85.8%,主要为女性, 31~<46岁,大专学历,初级职称,医生岗位,正式编制人员和工作年限5年及以下的人员.50%以上乡镇卫生人员认为薪酬福利是主动离职的影响因素.分维度来看,区域发展环境对不同性别的乡镇卫生人员离职的影响差异有统计学意义(P<0.05),工作情感负担和医院管理对不同学历人员的离职影响差异有统计学意义(P<0.05),工作情感负担对不同聘用形式人员的离职影响差异有统计学意义(P<0.05).结论 乡镇卫生人员主动离职率高且以女性为主,并且偏年轻化、核心化.薪酬待遇是主动离职的重要影响因素,区域发展环境对男性影响大,工作情感负担和医院管理对学历较高的人员影响大,工作情感负担对正式编制人员影响大.建议医院管理部门创新绩效工资分配机制,重视晋升机会、学习培训等非经济因素对人员引进与保留的影响.%Objective To understand the status of voluntary turnover of township hospital staff and its influencing factors,and to propose relevant countermeasures. Methods Site investigation method was used. A total number of eighty-six township hospitals in six counties of three provinces were randomly investigated for the status of voluntary turnover during 2012-2016. Two township hospitals from each county were selected to conduct investigation on influencing factors of voluntary turnover by self-made questionnaire based on the Price-Mueller Model. A total number of 251 health staff on duty were investigated. Results There were 1 432 outflow staffs of investigated township hospitals from 2012 to 2016,85.8% were voluntary turnover,and the majority were female,31-<46 years old, college degree,junior professional title,doctor position,formal staff and working for 5 years and below. More than 50% of the staff thought that salary affected their voluntary turnover behavior. The influence of regional development environment on turnover behavior of staff of different genders was different(P<0.05),the influence of work-related emotional burdens and hospital management on turnover behavior of employees with different degrees were different (P<0.05),and the influence of work-related emotional burdens on behavior of staff in different types of employment was different(P<0.05). Conclusion The rate of voluntary turnover of township hospital staff was high and the majority were women. The departing staff were mainly young and core staff. Salary was an important influencing factor,the regional development environment was more influential among men,work-related emotional burdens and hospital management had a greater impact on employees with higher education level,and work-related emotional burdens were more influential among formal staff. It is suggested that township hospitals innovate mechanism of distributing wages, and pay more attention to the influence of promotion,learning and training opportunities,and other non-economic factors on the introduction and retention of personnel.