通讯作者: 袁蓓蓓, beibeiyuan@bjmu.edu.cn

DOI：10.12201/bmr.202011.00017

A systematic review of the influence of the integrated reform of medical and health service system on the working motivation and behavior of medical workers

• 摘要：背景：医疗卫生服务体系整合型改革对各层面政策的调整会改变医务人员的工作环境及其从中获取的激励因素，而改革的连续性和体系绩效又依赖于人员工作动机。目的：探究医疗卫生服务体系整合型改革中医务人员工作动机和行为的改变。方法：采用系统综述法检索筛选文献，主题综合法提取文献信息，基于ERG理论分析工作动机影响机制。结果：纳入的19篇研究发现整合型改革有利于满足医务人员不同需求层次，提高了工作满意度或降低职业倦怠和工作压力。但是各类整合改革都存在薪酬体制改革滞后，不足以弥补工作量和工作压力增多的不足。结论：整合型改革会改变激励因素，建议注重各类政策的协调，改变传统收入结构、优化运行环境和资源获取渠道、打造横纵贯通的职业发展路径，特别注意基层机构发挥的作用，延申家庭医生团队内涵。

  关键词： 整合; 医务人员; 工作动机; 系统综述

   

  Abstract: The adjustment of policies and systems at all levels in The construction of integrated medical and health service system means the change of working environment as well as the incentive factors obtained from the environment, while to a certain extent ,the continuity and performance depend on the working motivation of medical works. Objective: To explore the changes of work motivation and behavior of health service providers during the construction and implementation of integrated medical and health service system. Methods: Systematic review method was used to retrieve and screen the literatures, thematic synthesis method was adopted to extract the literatures information, and then we analyzed the influence mechanism of work motivation based on ERG theory. Results: The 19 included studies found integrated reform had met different levels of the medical workers,influencing job satisfaction, job burnout and job stress positively. But every integrated pattern had relative lag compensation system, that was income cannot compensate for the negative effects of increased workload and work pressure. Conclusion: In the process of integrated reform, attention should be paid to the influence of the incentive factors. It is recommended to focus on the coordination of policy within and between integration, change the traditional income structure o, optimize the operating environment and resource acquisition, create a career path in both horizontally and vertically, specially pay attention on the role of primary health care institutions and their medical personnel, and extend the connotation of family doctor team.

  Key words: integrate medical worker work Motivation systematic review; ; ; 

  提交时间：2021-03-29

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
• html

• 图表

• 朱彦, ZHENG Jie, 李晓瑛, 杨啸林, HE Yongqun. 基本形式化本体BFO及中文版介绍. 2020. doi: 10.12201/bmr.202007.00009

  胡佳, 王清波, 郑英, 李力. 整合型医疗卫生服务体系理论框架的核心要素与演变特点——基于系统综述. 2022. doi: 10.12201/bmr.202111.00021

  雷萌, 罗银波, 汪瓒, 郭千千, 刘军安. 农村基层医务人员获得感与离职意愿的关系研究：以工作满意度为中介. 2021. doi: 10.12201/bmr.202010.00843

  于亚航, 袁蓓蓓. 工作动机在工作满意度和工作绩效中的链式中介效应研究. 2021. doi: 10.12201/bmr.202105.00015

  朱西敏, 胡银环, 吴晓悦, 张泽苗, 李佳怡, 漆振. 互联网+医疗背景下患者体验的评价：系统综述. 2021. doi: 10.12201/bmr.202107.00016

  代涛. “以人为中心”整合型医疗健康服务体系的关键要素研究. 2022. doi: 10.12201/bmr.202111.00019

  郑英. 我国区域整合型医疗卫生服务体系的治理逻辑与路径分析 ——基于多中心治理视角. 2022. doi: 10.12201/bmr.202111.00020

  芮晨, 黄磊. 基层医疗卫生机构工作人员离职意愿及其影响因素研究. 2021. doi: 10.12201/bmr.202012.00017

  许光建, 乔羽堃. 我国医疗服务价格调整与医保支付方式改革的联动机制研究. 2021. doi: 10.12201/bmr.202104.00018

  李琦, 袁蓓蓓, 何平, 马晓晨, 孟庆跃, 徐进. 英国“购买与提供分开”下的健康服务整合改革及启示. 2020. doi: 10.12201/bmr.202004.00029

• 序号	提交日期	编号	操作
  1	2020-11-12	bmr.202011.00017V1	下载

• 公开评论  匿名评论  仅发给作者 提交评论