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

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