人才作为一项对科技进步和社会经济发展而言都有着重大作用的资源要素。无 论对哪一家企业或机构来说，人力资源永远是发展的根本，尤其是对于医疗行业。 医学作为专业技术相对较强的特殊行业，医疗人才的培养需要花费更多的时间、人 力、物力和财力。人才流失过多造成人员体系不稳定，不利于医院整体服务水平和 竞争力的提升。市级中医院具有满足人民基本医疗卫生需求的功能、同时对推动中 医药事业的发展发挥重要作用，是我国医疗卫生事业中不可或缺的关键组成部分。 伴随着医疗市场竞争以及“中医西化”现象的加剧，中医院尤其是市县级基层中医 院面临着后继乏人的严峻局面。新生中医医疗人才缺乏及时有效的补充，同时现有 人才的大量流失，直接影响了中医队伍的建设与发展,影响到整体医疗团队水平的 提高。本文通过对Z市级中医院人力资源现状及其医护人才流失原因进行描述分析， 探讨了市级中医医院如何提高人力资源管理水平，提高人才队伍稳定性，从而促进 医院整体运作效率和服务水平的提升。 本文首先以 Z 市级中医院作为案例研究对象，针对其人力资源现状及医护人才 流失情况进行统计分析，找出其人员流失特点及产生的影响。然后在现有的 Price-Mueller(2000)模型的基础上根据影响员工离职的因素设计出调研问卷，对 Z 医院员工进行问卷调研，并结合对部分医院离职人员进行访谈了解他们离职原因的 真实原因以及促使他们离职的影响因素。最后本文根据 Price-Mueller(2000)模型 理论，结合管理学、人力资源及组织行为学相关理论，从社会因素、组织因素、个 人因素等角度分析影响医护人才流失的因素，并提出相应的解决思路和对策。 通过研究发现，由于医疗市场竞争以及“中医西化”的加剧，加之紧张的医患 关系现状以及住院医师规范化培训制度的实施等社会因素影响，市县级基层中医院 面临着医护人才大量流失、后继乏人的严峻局面。同时由于医院薪酬体系不完善、 绩效的核算办法不合理、员工身份差异同工不同酬、员工培养机制不合理、科室设 立不完善、医院文化流于形式等原因增加了员工的离职倾向。此外员工由于工作压 力大、生活压力影响，以及个人价值、发展追求难以得到实现等原因进一步导致了 人才流失的加剧。 针对以上 Z 市级中医院医护人才流失的原因，本文从加强政策支持、营造安全 的就医环境、完善薪酬考核体系、建立合理人才培养晋升制度、加强科室建设及医 院文化建设等方面，提出相应的解决思路和对策。希望能够对提高市级中医院的人 力资源管理水平、缓解人员流失加强人才队伍建设提供一些参考思路，从而进一步 提升医院综合服务能力，促进市级中医院医疗事业发展。 关键词：市级公立中医院；医护人才流失；影响因素Z 市级公立中医院医护人才流失原因及对策研究 I ABSTRACT As a resource factor, talent plays an important role in scientific and technological progress and social and economic development. No matter for any enterprise or organization, human resources are always the foundation of development，especially for the medical industry. Medical science as a special industry with strong professional technology, medical personnel training needs to spend more time, manpower, material and financial resources. The frequent occurrence of brain drains leads to the deepening of the instability of the system of too many medical personnel, which is not conducive to the improvement of the service level of hospitals and produces resistance to the enhancement of competitiveness. Municipal traditional Chinese medicine hospital has the function of meeting people's basic medical and health needs. At the same time, it plays an important role in promoting the development of TCM. Municipal traditional Chinese medicine hospital is an indispensable part of China's medical and health service, which is of key significance. With the intensifying competition in the medical market and the "westernization of Traditional Chinese medicine", county-level hospitals of traditional Chinese medicine are faced with a severe situation of lack of successors. The new TCM medical talents cannot be timely and effectively supplemented, meanwhile, the massive loss of existing talents, which directly affects the construction and development of TCM team and the improvement of the professional level of medical teams. Through the analysis of Z municipal hospital medical teams current status and medical brain drain reason, this paper discusses the municipal hospital of traditional Chinese medicine how to improve the level of medical team personnel management, how to improve the personnel stability, how to promote the hospital overall operation efficiency and service level of ascension. First of all, this paper takes Z City Hospital of Traditional Chinese Medicine as the object of study. The main content of the study is the current situation of human resource management and the loss of medical staff. Through statistical analysis, the characteristics of the brain drain and its impact are found out. On this basis, according to Price-Mueller (2000) model, aiming at the influencing factors of staff turnover, a questionnaire was designed for Z hospital employees. Furthermore, interviews were conducted with some hospital separating employee personnel to understand the real reasons for their departure and the influencing factors for their departure. Finally, according to price-Mueller (2000)摘要 II model theory, relevant theories of management, human resource and organizational behavior are applied to find out the influencing factors of doctors and nurses drain from the analysis of social factors, organizational factors and individual factors, and puts forward corresponding solutions. Through the research, it is found that due to the competition of medical market and the intensification of Westernization of TCM as well as the current tense doctor-patient relationship and the implementation of standardized training system for resident doctors and other social factors, county-level hospitals of traditional Chinese medicine are facing a severe situation of doctors and nurses drain and lack of successors. At the same time, due to the imperfect salary system, unreasonable performance accounting method, staff identity differences, different pay for the same work, unreasonable staff training mechanism, imperfect department establishment, hospital culture becoming a mere formality, the turnover intention of employees increased. In addition, due to the high work pressure, the impact of life pressure, as well as personal value, development pursuit is difficult to achieve and other reasons, further leading to the brain drain. In view of the above reasons for doctors and nurses drain in Z municipal TCM hospitals, this paper puts forward corresponding solutions and countermeasures from the aspects of strengthening policy support, such as creating a safe medical environment, perfecting the salary assessment system, establishing a reasonable talent training and promotion system，strengthen the cultural construction of departments and hospitals, and build a good working atmosphere. These measures can improve the construction and management level of municipal traditional Chinese medicine hospitals, alleviate the dilemma of brain drain, and provide some effective measures for strengthening human resource management, so as to further improve the professional level and service ability of hospitals and promote the vigorous development of the medical cause of municipal traditional Chinese medicine hospitals. KEYWORDS: municipal public hospital of traditional Chinese medicine; the brain drain; influence factorZ 市级公立中医院医护人才流失原因及对策研究 1 目 录 第一章 绪论 ····1 第一节 选题背景与研究意义1 一、选题背景·················1 二、理论意义·················1 三、现实意义·················1 第二节 国内外研究综述······2 一、国外学者针对员工离职问题的研究 ·2 二、国内学者关于医院人才流失的研究 ·2 三、文献评述·················4 第三节 研究目的与研究方法4 一、研究目的·················4 二、研究方法·················4 第四节 研究内容及本文解决的主要问题···5 第五节 可能的创新点和不足之处············5 一、可能的创新点 ··········5 二、不足之处·················5 第二章 概念界定和理论基搐··6 第一节 概念界定···············6 一、人才流失·················6 二、公立医院·················6 三、三级中医院··············6 第二节 理论基搐··············6 第三章 Z 市级公立中医院医护人才流失现状 9 第一节 Z 市级公立中医院简介及人力资源现状············9 一、Z 市级公立中医院简介·················9 二、Z 市级公立中医院人力资源现状及分析··············9目录 2 第二节 Z 市级公立中医院医护人才流失情况·············10 第三节 Z 市级公立中医院员工离职意愿调查分析·······12 一、问卷调查对象基本特征 ··············12 二、问卷调查对象样本合理性分析 ·····13 三、问卷调查结果统计分析 ··············14 第四节 Z 市级公立中医院离职医护人员典型个例访谈及分析··········15 一、离职医护人员访谈的实施 ···········15 二、被访谈者离职原因 ··16 三、离职人员访谈小结 ··18 第五节 Z 市级公立中医院医护人才流失的影响··········18 一、人才梯队建设受影响 ·················18 二、人力资源管理及人才培养成本增大 ·················18 三、研究成果受影响 ·····19 四、影响在职员工的工作积极性 ········19 五、导致病人的流失 ·····19 第四章 Z 市级公立中医院医护人才流失原因分析 ··········20 第一节 社会因素·············20 一、中医发展现状不理想 ·················20 二、医患关系紧张 ········20 三、住院医师规范化培训制度的实施 ··21 四、外部医疗机构对人才的吸引力 ·····21 五、医疗服务价格体系不完善 ···········21 第二节 组织因素·············22 一、薪酬绩效考核不科学完善 ···········22 二、医院建设及管理有待进一步加强 ··23 三、员工培养机制不合理 ·················24 四、医联体建设加重人力资源短缺 ·····25 第三节 个人因素·············25 一、工作压力大············25 二、个人发展得不到实现 ·················25 三、个人追求高层次的发展 ··············26Z 市级公立中医院医护人才流失原因及对策研究 3 四、个人背负的生活压力增大 ···········26 第五章 Z 市级公立中医院医护人才流失的对策研究 ·······27 第一节 社会层面·············27 一、加强中医发展政策支持 ··············27 二、营造安全的就医环境 ·················27 三、重视中医人才培养 ··27 四、规范中医医疗市场 ··28 五、完善医疗服务价格体系 ··············28 六、提升医护人员职业自豪感 ···········28 第二节 组织层面·············29 一、深化人事改革改进薪酬绩效考核 ··29 二、加强医院建设提高管理水平 ········30 三、合理人才培养晋升制度 ··············31 四、切实推行医联体的建设 ··············31 第三节 个人层面·············31 一、学会自我心理疏导 ··31 二、建立自己的职业规划 ·················32 三、合理规划学习工作安排 ··············32 四、不断提升生活幸福感 ·················32 第六章 结论····34