國立醫學中心級醫院的薪資制度受限於政府機關法今的規範,薪資制度採年資制及職級制造成不同工同酬的現象,致使績效好的醫師無法在薪酬上得到適度的回饋,因此可能影響其薪資滿足感因而降低服務意願致離職。 本研究假設薪資滿足感受到個人特性、對組織期望因素、及工作績效的影響;離職傾向受到組織期望因素及薪資滿足感的影響。利用線性結構模式分析方法來探討醫師薪資態度及相關行為間的關係。 研究對象為以某國立醫學中心級醫院專任主治醫師388人(回卷率為58.5%)。研究結果發現:影響離職傾向的直接因素:薪資滿足感、「家庭因素」、臨床績效、年薪所得。影響薪資滿足感的因素:「組織氣氛因素」、「薪資因素』、年薪所得、臨床及研究績效。顯示該個案醫院管理者在提高主治醫師留任意願的衆多措施之一,以改善目前薪資制度的缺失,維持及增進組織支持的氣氛,增加工作設計上的彈性,及改善工作量不平均的現象有助淤醫師的留任。
The case hospital, a public university medical center, has a rigid payroll system due to tight governmental regulation. The pay is based on a physicians tenure and hierarchy which may lead to the physician' low job satisfaction, and consequently high propensity to leave the hospital. Therefore, the purpose of this study is to explore the factors influencing the propensity of full-time physicians to leave. Based on literature review, we hypothesized that the physicians' satisfaction with pay will be affected by personality, expectation to work environment, and work performance, and that physician's intention to leave the job will be influenced by the expectation to work environment and satisfaction with pay. The survey consisted of, 388 visiting staffs being selected from this case hospital, of which 227 sample cases responded to this questionnaire (58.5%). Using the Linear Structural Equation modeling, we analyzed the association between the satisfaction with pay and their propensity to leave. The main study results were that the factors directly affected the intention to leave were the satisfaction with compensation, family factor, clinical performance, and research performance. Based on our study results, we suggest that the case hospital should improve the physician payroll system, facilitate the organization supporting mechanism, increase the flexibility of job design, and correct the unbalanced work load.