关键词: 医联体, 县级医院, 医生, 离职倾向

Abstract: Objective　To understand the change of doctors' working status from single hospital development to the medical treatment partnership system in order to provide a basis for promoting the construction of partnership system.Methods　Cluster sampling method was used to select physicians from Yicheng People's Hospital，Yicheng Hospital of Traditional Chinese Medicine，Dangyang People's Hospital and Dangyang Hospital of Traditional Chinese Medicine as investigation subjects from April to July 2017.Working status questionnaire of medical staff was used to evaluate work pressure，interpersonal relationship，professional quality，performance assessment and economic income，and turnover intention scale was used to investigate current turnover intention of physicians in counties.Results　Of the 210 clinicians，181 returned responsive questionnaires，with a response rate of 86.2%.After the construction of medical treatment partnership system，scores of work pressure，interpersonal relationship，professional quality，performance assessment and economic income of physicians in counties were （1.77±2.63），（2.37±2.63），（2.79±2.85），（1.15±2.39），（0.82±2.08），respectively.Those aged over 50 years had lower scores in interpersonal relations than those <50 years，and lower scores in professional quality than those <39 years （P<0.05）．The scores of interpersonal relationship in physicians with bachelor degree or above were higher than that of physicians with college diploma.Doctors with graduate degree or above had higher scores of professional quality than physicians with college diploma，and higher scores of performance assessment than physicians with bachelor degree or below（P<0.05）．The scores of working pressure，interpersonal relationship，professional quality，performance assessment and economic income of doctors without budgeted posts were higher than those of the doctors with budgeted posts，and the scores of above dimensions of doctors from non-compact medical treatment partnership system were lower than those of doctors from compact medical treatment partnership system（P<0.05）．There was a statistically significant difference in turnover intention among doctors with different results of work pressure，interpersonal relationship and economic income （P<0.05）．Conclusion　Doctors hold a positive attitude towards the medical treatment partnership system，while the negative influences from the system，such as working pressure，interpersonal relationship and economic income，may increase the turnover intention.Therefore，medical examination under the partnership system should takes into account the business changes after the system is carried out.In the reform of performance assessment，the social value of doctor cooperation should be reflected in order to promote this cooperation.

Key words: Medical treatment partnership system, County hospital, Physician, Turnover intention