The Status And Influencing Factors Of Health Worker Motivation In Public Hospitals

BackgroundHealth worker is the core competitiveness of hospital development,and the motivation of their work will directly affect the work efficiency,affect the satisfaction of patients.Medical personnel,as the direct experience reur and promoter of public hospital reform,are the main body of public hospital reform,and the reform policy ultimately depends on medical personnel to implement and implement,and their motivation will directly affect the effect of the reform.The external performance of medical personnel’s motivation is mainly reflected in job satisfaction,willingness to leave,job burnout and so on,at this stage,the job satisfaction of medical personnel in China is not high,the situation of separation is becoming more and more serious,the rate of job burnout is high,and there are still many problems to be solved in improving the motivation of medical personnel.Mobilizing the motivation of medical personnel is the way to realize the reform of public hospitals,and with the in-depth development of public hospital reform,how to effectively mobilize the motivation of medical personnel has become a hotspot and difficult problem in society.ObjectiveTo understand the current situation of the motivation of medical personnel in public hospitals,to systematically analyze the factors of medical personnel’s motivation from the three dimensions of individual,organization and society,and to provide a policy basis for improving the motivation of medical personnel in China and optimizing the internal management of public hospitalsMethodsThis study is a cross-sectional study,using layered,multi-stage sampling method,selected Sichuan,Hunan and Zhejiang provinces 9 including provincial,municipal,county-owned public hospitals to conduct on-site surveys;Pharmacists and technicians conducted questionnaires and conducted one-on-one interviews and focus group interviews around research topics.The data are systematically analyzed by descriptive analysis,one-factor anova analysis,Pearson-related analysis,regression analysis,and the qualitative data is analyzed using Nvivo 12.0.ResultsIn this study,a total of 3219 questionnaires,2848 valid questionnaires,questionnaire efficiency of 88.47%,one-on-one interviews with 76 hospital administrators,focus group interviews 27 groups.The results are as follows:(1)The overall score of health worker’s motivation was 3.85 points,which was at a moderate lyse level.The dedication dimension scored the highest score of 4.05 points among the dimensions,and the dynamic dimension scored the lowest,at 3.64.(2)The differences in the work motivation of medical personnel at different ages,education levels,working years,administrative positions,nature of employment and hospital level are statistically significant(all P 0.05),and the results of the analysis of logistic multi-factors show that the motivation of medical personnel is related to academic qualifications,administrative positions,employment properties,hospital level.In provincial hospitals,the difference slotofation of medical personnel for different years of work and administrative positions is statistically significant,in municipal hospitals,the differences in the motivation of medical personnel of different ages and employment properties are statistically significant,and in county hospitals,the differences in the motivation of medical personnel of different genders,ages,academic qualifications,working years,administrative positions and employment properties are statistically significant.(3)The overall score of the internal service quality evaluation of the hospital was 3.90 points,the internal service interaction quality score was the highest,3.94 points,and the internal work arrangement quality score was the lowest,3.81 points.The analysis of Person shows that the total quality of service and the total score of each dimension with work motivation and the total score of work are significantly positively correlated with each dimension(R<0.6,P<0.05).The regression results show that the sense of job stability,the reasonable distribution of workload,the management level of hospital leadership and the relationship between colleagues are the main factors affecting the motivation of medical personnel.The main factors of provincial hospitals are the reasonable distribution of workload,the recognition of work by leaders and colleagues,and the relationship between colleagues.(4)The results of the focus group interview showed that the media publicity,social cognition,doctor-patient relationship,medical insurance policy,drug zero price difference policy will affect the motivation of medical personnel to some extent.Conclusion and suggestionsThe overall motivation of health worker in public hospitals in the sample area is at a medium level,which can improve the space.At the individual level,the motivation of medical personnel is related to academic qualifications,administrative posts,nature of employment,hospital level,the higher the degree,the lower the motivation of work,and the lower the motivation of medical personnel with administrative posts and non-preparation and approval system.At the organizational level,the level of internal work arrangement in public hospitals has the greatest impact on the motivation of work,and the reasonable distribution of workload in the internal management of provincial hospitals,the degree of recognition of work by leaders and colleagues,and the relationship between colleagues are the important factors of employee motivation.The sense of work stability and leadership management in municipal hospitals and county hospitals,the sense of security of working environment in municipal hospitals,the income and welfare treatment of county hospitals are important factors influencing the motivation of medical personnel.At the social level,inappropriate publicity and lack of social cognition will have a negative impact on the motivation of medical personnel,medical insurance policy limits the motivation of work to a certain extent,and the policy of zero-plus drugs reduces the income of hospitals and thus affects the motivation of pharmacists.Based on the results and findings,the following policy recommendations are made:(1)Improve the hospital’s internal management system and improve the hospital’s management level;(2)Improve hospital risk prevention awareness and improve the health worker’s practice environment(3)Improve the salary level of hospital health worker and establish an incentive salary system;(4)Strengthen the construction of hospital culture and create a hospital culture with"employees as the core";(5)Create a social atmosphere of respecting doctors and protecting the society,and improve the social status of health worker.