乡镇卫生院护理人员工作偏好研究：基于离散选择实验

摘要

Objective:To analyze the job preferences of nurses at township health centers(THC),and to provide research evidence for making retention policies for nurses working at THC. Methods:One hundred and sixty-four nurses were selected from Shandong,Anhui and Shanxi provinces and were investigated based on a discrete choice experiment (DCE). Conditional logistic regression was used to analyze data. Results:All attributes had a statistically significant influence on job preferences of nurses working at THC(P<0.001). The odds ratio of staying in the job was 12.16,when comparing monthly income 8 000 RMB yuan to 2 000 RMB yuan,10.59 when comparing better education conditions to worse education conditions for children,and 7.81 when comparing formal position to no position.“Monthly income 4 000 RMB yuan with formal position”and“monthly income 4 000 RMB yuan with improvement of education conditions for children”were two intervention packages predicted to retain around 98%of the nurses working at THCs. Conclusion:Income,education conditions for children and formal position most influenced the retention of nurses at THC. The designed intervention packages based on discrete choice experiment could provide important evidence for making the retention policy of nurses at THCs.%目的：通过分析乡镇卫生院护理人员工作偏好，为基层留住护理人员提供政策参考。方法：基于离散选择实验的方法，抽取山东、安徽、陕西三省共164名乡镇卫生院护理人员进行问卷调查，利用条件logistic模型进行分析。结果：纳入分析的6项工作属性都具有统计学显著性（P<0.001）。其中月收入8000元与2000元相比，留在基层工作的OR为12.16，子女有好教育条件与没有相比，OR为10.59，有编制与无编制相比，OR为7.81。“月收入4000元+提供编制”和“月收入4000元+改善子女教育条件”两种干预组和，预计能保留98%以上的基层护理人员。结论：对乡镇卫生院护理人员来说，最重要的工作属性是收入水平、子女教育条件和编制。根据离散选择实验结果所设计的政策干预包将为基层护理人力保留政策发展提供重要参考。