新型冠狀病毒疫情對於新北市醫事人員離職率之影響

Abstract

研究背景與目的： 108年底新型冠狀病毒的出現，帶給醫療保健系統、專業人員和管理系統帶來了前所未有的壓力，本研究希望藉由新北市各類醫事人員執業登記資料，了解各類醫事人員於新型冠狀病毒疫情期間離職情形，探討各類醫事人員離職率，並經由數據分析離職人員職業類別、性別、年齡族群、執業登記機構型態別，並期望研究結果能讓各單位對於員工能持續提供各類支持，並讓管理者有機會得以重新省思、惕勵與檢視過去在相關人員管理、行政管理和環境管理等是否有不足，以營造良好的醫療工作環境。 研究方法： 在雙變項部分，本研究是以卡方檢定分析人員及醫事機構特性，發現性別、職業別、機構層級別、區域別、權屬別有顯著相關，另以ANOVA檢定方法進行年齡分析，亦顯示為顯著相關。在多變項部分，利用GEE重複量測106年、107年、108年、109年、110年、111年每個醫事人員歷年的資料，並控制醫事人員特性、醫事機構特性等變項，探討各變項與離職的關係。 研究結果： 研究資料顯示總計26萬9,617筆之樣本數，109年度及110年度離職率相對低於非疫情期間，女性多於男性，各年齡平均值介於37-42歲，於職業別部分，研究顯示醫師及其他醫事人員離職率低於護理人員，醫學中心及區域醫院離職率較低，但地區醫院、長照機構及其他機構之離職率相對較高，並以長照機構的離職率佔比最高，在醫療分區上，以中區及南區離職率相對較高，並且以營利機構數為最多。 結論： 本研究發現醫事人員的離職率在新冠疫情期間相對低於非疫情期間，另外研究可發現護理人員的離職率高於其他醫事人員的離職率，未來在護理工作分配及權衡上可多加著墨，並考量護理人員實際需求，改善工作環境，提供合理、對等的工作薪資，另外長照機構的離職率於各機構類別為最高，醫學中心的離職率最低，醫院福利待遇相較長照機構相對較佳，薪資及福利待遇都是導致長照機構人力流失的其中一項因素，另外可發現營利機構的離職率高於非營利機構，各營利單位機構管理者可思考，如何提供優於公立或非營利機構的福利措施，以留住醫事人力。

Research Background and Objectives: The emergence of the covid-19 at the end of 2019 brought unprecedented pressures to the healthcare system, professionals, and management systems. This study aims to understand the resignation patterns of various medical professionals in New Taipei City during the COVID-19 pandemic. By analyzing the practice registration data, this study aims to explore the resignation rates of these professionals, focusing on their occupational categories, gender, age groups, and types of institutions they were registered with. The goal is to provide insights that could help organizations continually offer various forms of support to their staff and enable managers to reflect, encourage, and review past practices in personnel, administrative, and environmental management to foster a better medical working environment. Research Methods: In the bivariate analysis, this study used chi-squared tests to analyze the characteristics of the personnel and medical institutions, finding significant correlations with gender, profession, institutional level, regional differences, and hospital ownership. An ANOVA test was conducted for age analysis, also showing significant correlation. In the multivariate part, the study utilized Generalized Estimating Equations (GEE) to analyze the longitudinal data of medical professionals from 2017 to 2022, controlling for variables like personnel and medical institution characteristics, to study their relationships with resignation. Research Findings: The data encompassed 269,617 samples, showing that the resignation rates in 2020 and 2021 were relatively lower compared to non-pandemic periods. Women constituted a higher percentage of the resignations, with the average age ranging from 37 to 42 years. Regarding professional categories, doctors and other medical staff had lower resignation rates compared to nursing staff. Medical centers and district hospitals had lower resignation rates, whereas district hospitals, long-term care service institutions, and other institutions had higher rates, with long-term care service institutions having the highest. Geographically, the central and southern medical districts had relatively higher resignation rates, with non-profit institutions having the highest number. Conclusion: This study found that the turnover rate of medical staff during the COVID-19 epidemic was relatively lower than during non-epidemic periods. However, it was observed that the resignation rate among nursing staff was higher than that of other medical professionals. Future considerations should focus more on the allocation and balancing of nursing work, taking into account the real needs of nursing staff, improving work environments, providing reasonable and equitable salaries. Long-term care service institutions had the highest resignation rate among all types of institutions, while medical centers had the lowest. Hospital benefits and compensation are relatively better compared to long-term care service institutions, which is one factor contributing to staff turnover in these facilities. Additionally, for-profit institutions had higher resignation rates than non-profit ones, therefore for-profit institutions' managers should consider offering benefits that are competitive with public or non-profit institutions to retain healthcare workers.