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背景瑞士正面临着初级医疗医生短缺的问题,政府机构因此提出了广泛的初级医疗医生干预措施。本研究旨在根据相关医生群体(医院医生和初级医疗医生)的接受度和认为的障碍,找到应被重点考虑的干预措施。方法本研究在2014年夏季进行。通过在线调查问卷,收集关于人口统计学、工作情况和未来计划的资料。参与者对22项促进初级医疗的干预措施的有效性进行排序。运用李克特量表(Likert scale)对促进初级医疗的干预措施进行评分,如干预措施被至少80%的参与者评分4分或5分,则该干预措施被列为高接受度干预措施。通过Mann-Whitney U检验对结果进行验证,分析参与者是否得出不同排序。本研究假定多次测试的邦费罗尼校正得到双侧P<0.05为具有统计学意义。结果总共230名医生完成调查(回收率为58.4%)。共69名初级医疗医生和66名医院医生被纳入分析。其中,14名初级医疗医生因为退休预备停止临床实践,然而只有8名医院医生计划成为初级医疗医生。初级医疗医生接受度最高的干预措施是增加报销,而医院医生接受度最高的干预措施是家庭友好型措施。初级医疗医生和医院医生均认为对初级医疗培训生的资助是一项非常有用的干预措施。结论针对即将退休和考虑提早退休的初级医疗医生的干预措施并不能扭转初级医疗医生的短缺。因此,政府应重点鼓励医院医生投身初级医疗事业,具体措施是为初级医疗培训生提供资金支持和为家庭友好型干预措施进行投资。
Background Switzerland is facing a shortage of primary care physicians and government agencies have therefore proposed a wide range of primary care physician interventions. The aim of this study is to find interventions that should be given priority consideration based on the acceptance and perceived obstacles of the relevant groups of physicians (hospital doctors and primary care physicians). Methods The study was conducted in the summer of 2014. Collect information on demographics, work conditions, and future plans through an online survey. The participants ranked the effectiveness of 22 interventions that promote primary care. The Likert scale was used to rate primary care interventions. If interventions were scored 4 or 5 with at least 80% of participants, the intervention was classified as a high-accepting intervention. The results were validated using the Mann-Whitney U test to analyze whether participants ranked in different orders. This study assumes that multiple tests of the Bonferroni correction of bilateral P <0.05 was considered statistically significant. Results A total of 230 doctors completed the survey (recovery rate was 58.4%). A total of 69 primary medical doctors and 66 hospital doctors were included in the analysis. Of these, 14 primary care physicians stopped clinical practice because of retirement, yet only eight hospital doctors plan to become primary care physicians. The highest-priority interventions for primary care physicians were to increase reimbursement, while the most accepted intervention for hospital doctors was family-friendly. Both primary care physicians and hospital doctors consider funding primary care trainees a very useful intervention. Conclusion Interventions for primary care physicians who are about to retire and consider early retirement do not reverse the shortage of primary care physicians. Therefore, the government should focus on encouraging hospital doctors to join the primary care business by providing financial support to primary medical trainees and investing in family-friendly interventions.