桃園地區藥師在健保總額預算期間的工作倦怠及離職意向

Burnout and quit intention among pharmacists in Taoyuan while implementation of global budget payment system of the National Health Insurance Program

韓沂(Yi Han) ； 林雪蓉(Sheue-Rong Lin) ； 史麗珠(Lai-Chu See)

《中華職業醫學雜誌》 26卷4期 (2019/10) Pp. 263-275

摘要

目的：在健保總額預算後，醫療人員的工作量及壓力增加，導致工作倦怠甚至有離職的打算。本研究探討健保總額預算期間，藥師的工作倦怠、離職意向，並分析上述項目的影響因子。方法：採用問卷調查，對桃園縣藥師以分層比例隨機取樣，邀請藥師填寫問卷。以工作倦怠－醫療行業調查（MBI-HSS）（含三個向度：情緒耗竭、去人性化、個人成就）來測量工作倦怠。結果：2006年7-12月得有效問卷63份。因應方式的平均數為42.1、情緒耗竭的平均數為21.8、去人性化為7.6、個人成就為34.3，49.2%的藥師有離職意向。多變量分析結果顯示，醫療院所層級（p=.0009）、婚姻狀況（p=.0091）、控制性因應（p=.0391）與情緒耗竭有顯著意義。年齡（p=＜.0001）、工作時間選擇（p=.0119）與去人性化有顯著意義。而個人成就則沒有達統計顯著意義的因子。性別（p=.0010）、情緒耗竭（p=.0061）對離職意向有顯著意義。結論：總額預算期間，藥師在情緒耗竭及去人性化的分數不嚴重，而個人成就的分數較高。離職意向的原因與情緒耗竭和性別有關。

關鍵字

工作倦怠 ； 離職意向 ； 藥師 ； 健保總額預算

並列摘要

Objectives: After the implementation of global budget, burnout and intention to quit their job among medical workers is resulted from increased workload. In this study, we investigated the magnitude of job burnout and quit intention, and analyzed factors associated with burnout and quit intention among pharmacists during the implementation of the global budget payment system of the Taiwan National Health Insurance. Methods: A study with a stratified and proportional random sampling was used to obtain the study sample in Taoyuan, Taiwan. Maslach burnout inventory-human service survey (MBI-HSS) were used to assess the three dimensions of burnout (emotional exhaustion, depersonalization, and personal accomplishment). Results: From July to December 2006, 63 pharmacists were obtained. The mean score of coping was 42.1, emotional exhaustion was 21.8, depersonalization was 7.6, and personal accomplishment was 34.3, respectively. 49.2% of pharmacists had an intention to quit their job. Multivariate analysis reveals that pharmacists’ medical institution level (p=.0009), marital status (p=.0091), controlling coping (p=.0391) was significantly associated with emotional exhaustion. Age (p=＜.0001) and working hours through choice (p=.0119) was significantly associated with depersonalization. However, there was no factor associated with personal accomplishment. Gender (p=.0010) and emotional exhaustion (p=.0061) was significantly associated with quit intention. Conclusions: During implementation of global budget payment system, pharmacists had mild problem of emotional exhaustion and depersonalization, and high level of personal accomplishment. The reason of quit intention was gender and emotional exhaustion.

並列關鍵字

burnout ； quit intention ； pharmacists ； global budget