医护人员参与多学科团队:中国三级公立医院的离散选择实验

IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Journal of Multidisciplinary Healthcare Pub Date : 2024-09-07 DOI:10.2147/jmdh.s473675
Jie Jia, Tao Sun, Jiamin Tang, Kaidi Sun, Zhengnan Meng, Hailong Zhu, Xianhong Huang
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引用次数: 0

摘要

目的:医护人员的参与对于多学科团队(MDT)合作模式的有效实施至关重要。我们确定了影响医护人员参与三级医院多学科团队的关键因素:为了明确离散选择实验(DCE)的属性和水平,我们进行了有针对性的文献综述,并对 MDT 服务提供者进行了深入访谈。随后,我们设计了一个离散选择实验来评估医护人员对参与 MDT 的偏好,以及薪酬补贴、领导重视、患者参与、质量评估、工作强度和病例复杂性等因素的影响。一个条件对数模型估算了每个属性的效用。将非经济属性和经济属性的系数取负比,得出支付意愿估计值。我们还进行了一系列政策模拟分析:200 名医疗保健专业人员填写了问卷,其中 180 份有效答卷用于分析。所有属性均具有统计学意义。领导重视和工作强度是影响员工参与 MDT 意愿的主要因素,其次是质量评估和薪酬补贴。受访者之间存在明显的偏好差异;与中层员工相比,高级医护人员认为患者参与更有助于提高参与度。政策模拟显示,将领导关注从 "忽视 "转变为 "重视 "将使员工选择参与 MDT 的概率从 24.4% 提高到 66.98%:领导的关注是医护人员在 MDT 中的首要关注点。为有效激励员工参与 MDT,政策制定者应采取综合方法,考虑工作动机和个人背景,包括具有竞争力的薪酬待遇和积极的工作环境。他们应同时引入 MDT 病例复杂性衡量工具,以优化资源分配。通过制定有针对性的培训计划、晋升途径和个性化职业发展计划来满足工作人员的独特需求和职业抱负也至关重要。 关键词:多学科医疗服务;参与动机;医疗服务研究;离散选择实验
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Participation in Multidisciplinary Teams Among Healthcare Professionals: A Discrete Choice Experiment in Tertiary Public Hospitals in China
Purpose: Healthcare professionals’ participation is crucial for the efficient implementation of multidisciplinary team (MDT) collaboration models. We identified the key factors influencing healthcare professionals’ preference to participate in MDTs in tertiary hospitals.
Methods: To clarify the attributes and levels of the discrete choice experiment (DCE), we conducted a targeted literature review and conducted in-depth interviews with MDT service providers. Following this, a DCE was designed to evaluate healthcare professionals’ preferences for MDT participation, and the influence of factors such as salary subsidies, leadership attention, patient participation, quality assessment, working intensity, and case complexity. A conditional logit model estimated the utility of each attribute. Willingness-to-pay estimates were derived by taking the negative ratio of the coefficients of non-economic and economic attributes. A series of policy simulation analyses were conducted.
Results: Two hundred healthcare professionals completed the questionnaire, with 180 valid responses used for analysis. All attributes were statistically significant. Leadership attention and working intensity were the primary factors influencing staff willingness to participate in MDTs, followed by quality assessment and salary subsidies. Significant preference differences were observed between respondents; compared with mid-level staff, senior-level healthcare professionals believed patient engagement would be more helpful in boosting participation. The policy simulation showed that changing leadership attention from “neglect” to “emphasis” would increase the probability of staff choosing to participate in MDTs from 24.4% to 66.98%.
Conclusion: Leadership attention was the primary concern for healthcare professionals in MDTs. To effectively motivate staff participation in MDTs, policymakers should adopt a holistic approach that considers work motivation and individual backgrounds, including competitive salary packages and a positive work environment. They should concurrently introduce MDT case complexity measurement tools to optimize resource allocation. Addressing staff members’ unique needs and career aspirations by creating targeted training programs, pathways for advancement, and personalized career development plans are also crucial.

Keywords: multidisciplinary medical services, participation motivation, health services research, discrete choice experiment
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来源期刊
Journal of Multidisciplinary Healthcare
Journal of Multidisciplinary Healthcare Nursing-General Nursing
CiteScore
4.60
自引率
3.00%
发文量
287
审稿时长
16 weeks
期刊介绍: The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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