| 引用本文：赵世超,辛明泽,唐子茜,等.山东省基层卫生技术人员的行政负担及其对职业倦怠的作用机制：基于探索性时序设计的混合方法[J].中国卫生政策研究,2025,18(9):31-38 |
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| 山东省基层卫生技术人员的行政负担及其对职业倦怠的作用机制：基于探索性时序设计的混合方法 |
| 投稿时间：2025-08-17 修订日期：2025-09-11 PDF全文浏览 HTML全文浏览 |
| 赵世超1，辛明泽1，唐子茜1，董雅芳1，李禾熙1，马慧芬2，王涛3 |
| 1.山东师范大学公共管理学院 山东济南 250014;2.山东第一医科大学医药管理学院 山东泰安 271016;3.济南市中心医院 山东济南 250013 |
| 摘要:目的 分析基层卫生技术人员行政负担的表现与成因，探究其对职业倦怠的作用机制。方法 采用探索性时序设计，对山东省基层卫生技术人员开展两阶段研究，第一阶段访谈175人，第二阶段问卷调查1 096人并访谈107人。结果 认为迎检、文件、报表和会议四类行政负担“非常重”或“比较重”的人员比例分别为62.7%、54.8%、51.8%和24.4%。结构方程模型显示，行政负担对职业倦怠的直接效应为0.150，通过角色冲突的间接效应为0.093。定性分析发现，行政负担主要源于公共卫生服务的痕迹管理与医保政策规定，并通过精力冲突和价值冲突两条路径作用于职业倦怠。结论 基层卫生技术人员面临较重的行政负担，易通过角色冲突提升职业倦怠风险。应通过优化考核检查、精简数据填报、完善痕迹管理、推动协同治理来实现系统性减负。 |
| 关键词:行政负担 职业倦怠 角色冲突 基层卫生技术人员 混合研究方法 |
| 基金项目:国家自然科学基金青年项目（72204150） |
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| Administrative burden among primary healthcare professionals and its impact mechanism on job burnout： An exploratory sequential mixed-methods study |
| ZHAO Shi-chao1, XIN Ming-ze1, TANG Zi-qian1, DONG Ya-fang1, LI He-xi1, MA Hui-fen2, WANG Tao3 |
| 1.School of Public Administration， Shandong Normal University， Jinan Shandong 250014， China;2.School of Medical Management， Shandong First Medical University， Tai'an Shandong 271016， China;3.Jinan Central Hospital， Jinan Shandong 250013， China |
| Abstract:Objective To examine the manifestations and causes of administrative burden among primary healthcare professionals， and to explore its impact on job burnout through the mediating role of role conflict， providing theoretical and empirical support for governance-level burden-reduction strategies.Methods An exploratory sequential mixed-methods design was employed， focusing on primary healthcare professionals in Shandong Province. In the first phase， in-depth interviews were conducted with 175 participants； in the second phase， a questionnaire survey of 1，096 participants and follow-up interviews with 107 participants were carried out.Results The proportions of respondents who reported “heavy” or “very heavy” burdens were 62.7% for inspection， 54.8% for documentation， 51.8% for reporting， and 24.4% for meetings. Structural equation modeling showed that administrative burden had a direct effect on job burnout （0.150） and an indirect effect through role conflict （0.093）. Qualitative findings further indicated that administrative burden largely stemmed from public health traceability requirements and medical insurance policies， and operated through both resource-based and value-based conflicts.Conclusions Primary healthcare professionals face considerable administrative burdens， which may heighten job burnout through role conflict. Governance reforms should optimize inspection and assessment， streamline data reporting， refine record-keeping， and promote collaborative governance to break the chain of institutional pressure leading to burnout. |
| Key words:Administrative burden Job burnout Role conflict Primary healthcare professionals Mixed-methods research |
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