A Study On Influential Factors Of Turnover Intention And Turnover Behavior Of Pediatricians In Public Medical Institutions

1.ObjectivesSince the reform of the national medical and health system,the level of children’s medical and health services has been greatly improved,but the shortage of pediatricians has become increasingly serious.The loss of pediatricians is higher than that of other specialties,and the stability of the pediatrician team needs to be strengthened.Children are the future of the country.The healthy growth of children is related to the national people’s livelihood.Pediatricians are the guardians of children’s health.Public medical institutions are the main body of children’s medical and health protection.The shortage and churn of pediatricians in public medical institutions seriously affect children in China.By comparing and analyzing the influencing factors of in-service pediatricians’ leaving in public medical institutions and the influencing factors of the outgoing pediatricians’ turnover behavior,we can find out the deep-seated motivation of pediatricians’ turnover and propose countermeasures and suggestions.2.FieldsAs the pediatrician’s turnover intention and turnover behavior involve different states of the pediatrician’s turnover process,the selection of research objects is inconsistent.The research object of turnover intention is in-service pediatricians in public medical institutions nationwide,and hopes to compare the research on the turnover intention of pediatricians in public medical institutions in Guangdong and find the possible differences.The object of the influencing factors of the intention behavior is to select the retired pediatrician in the public medical institution in Guangdong.Theoretically,comparing with the study on the turnover intention of pediatricians in public medical institutions in Guangdong,we find that there is a relative consistency with the turnover intention of pediatricians in public medical institutions nationwide;In practice,it is difficult to obtain the data of outgoing pediatricians across the country,so we selected the outgoing pediatricians in public medical institutions in Guangdong for investigation.3.Methods3.1 Document analysisSearch for pediatrician departures by searching the keywords "Pediatrician turnover","Pediatrician turnover intention","Pediatrician turnover behavior" on relevant websites such as China Journal Net,Wanfang Database,Weipu Journal Full-text Database,PubMed,Web of Science and other relevant websites Documents,study the current status and development trends of domestic and foreign research on the influencing factors of turnover intention and turnover behavior,and sort out the research ideas of the influencing factors of turnover intention and turnover behavior in public medical institutions.3.2 Questionnaire survey methodIn the basic science of literature analysis and review,the questionnaire of pediatricians’ turnover intention was designed,and the occupational identification,job satisfaction and turnover intention were selected for conceptual operation and quantification.Using a multi-stage stratified random sampling method,a total of 4906 pediatricians on duty were selected for the survey.Based on the literature analysis and review,we designed a questionnaire on the influencing factors of pediatrician’s turnover behavior,selected the relevant influencing factors of the turnover behavior for conceptual operation and quantification,and conducted a questionnaire survey on the influencing factors of pediatrician’s turnover behavior in public medical institutions in Guangdong.Using snowball sampling,a total of 407 retired pediatricians were interviewed for investigation.3.3 Statistical analysisBased on survey data,combined with SPSS,SPSS Process,AMOS and other analytical tools,perform descriptive analysis,analysis of variance,correlation analysis,regression analysis,intermediary effect analysis,exploratory factor analysis,cluster analysis and structural equation model Statistical processing,etc.,to understand and perceive the current status of pediatricians’ turnover intention in public medical institutions nationwide and related influencing factors,to explore the impact of occupational identity and job satisfaction on pediatricians’ turnover intention;to understand and perceive the current pediatricians’ turnover behavior in public medical institutions in Guangdong.3.4 Comparative analysisBy comparing and analyzing the influencing factors of pediatricians’ turnover intention and turnover behavior,in-depth analysis of the reasons for pediatricians’turnover,and proposing strategies to alleviate the shortage and turnover of pediatricians.4.Results4.1 Analysis of turnover intention of pediatricians in public medical institutions(1)Through ANOVA analysis of variance,we can know that age,education,marital,region,type of practice setting,grade of practice setting,professional title level,years in practice,hospital beds(workload),weekly rest days and monthly income have a statistically significant to turnover intention.(2)Through Hierarchical regression,it can be seen that age,gender,weekly rest days,occupational identity,internal job satisfaction and external job satisfaction have a statistically significant to turnover intention.When external job satisfaction variable is included,the hierarchical regression of the grade of practice setting and monthly income variables are then insignificant.(3)The mediating effect analysis shows that internal job satisfaction and external job satisfaction are the mediating variables of the influence of professional identity on turnover intention,which play a part of the mediating effect.4.2 Analysis of influencing factors of pediatricians’ turnover behavior in public medical institutions in Guangdong(1)According to the analysis of the current status of pediatrician turnover,the total number of pediatricians in the public medical pediatricians in Guangdong is on an upward trend from 2008 to 2018.The number of practitioners who changed the scope of practice accounted for 78.65%of the total.The loss of young and middle-aged pediatricians is serious.(2)The analysis of the reasons for leaving can be seen that career development,work pressure and social status are important reasons for their departure.At the same time,salary and benefits are not the main reason.(3)Analysis of structural equation model of influencing factors of turnover behavior shows that organization and reward factors and personal and development factors have the highest correlation(0.53),followed by work and prospects and social and family factors(0.37),work and prospects relevance to the individual and development(0.21).Unit culture is the main observed variable of organization and reward.Social identity is the main observed variable of work and prospect.Promotion and development opportunities are the main observed variables of individual and development,and family relationship is the main observed variable of society and family.5.Conclusion(1)A comparative analysis of pediatricians’ turnover intention and turnover behaviors in public medical institutions shows consistent characteristics:young and middle-aged pediatric doctors have a strong turnover intention,and this part of pediatricians has the most serious turnover;pediatricians in general hospitals have higher turnover intention and turnover behaviors;pediatricians in primary medical institutions have higher turnover intention and turnover behaviors;the lower the income,the pediatricians’ turnover intention and turnover behaviors the stronger.(2)A comparative analysis of pediatrician’s turnover intention and turnover behavior in public medical institutions shows different characteristics:pediatricians in relatively underdeveloped areas have a higher turnover behavior,while pediatricians in more developed areas have a higher turnover behavior;monthly income is the most unsatisfactory factor of pediatricians in job satisfaction surveys,but monthly income is not the primary factor of turnover behavior;in the occupational identity survey,the pediatricians’ occupational identity is at a moderate level,but social identity is the main observed variable of work and prospect;promotion and development opportunities are the main observed variables of personal and development,and also the primary reason for leaving.(3)An analysis of the motivations for pediatricians’ intention can be found that the lack of pediatricians’ sense of identity and value is the deep-seated motivation for their intention,which is mainly manifested in low self-perceived social recognition,inconsistent labor and rewards,and uneven professional promotion.Therefore,the professional promotion and development mechanism of pediatricians should be established,and effectively relieve the work pressure of pediatricians,and actively build harmony doctor-patient relationship,and accelerate the training and construction of pediatricians,and rationally optimize the allocation of pediatric medical resources,and the salary and treatment of pediatricians should be greatly increased.These policies will promote the healthy development of the entire pediatric field and lay a solid foundation for children’s health.