医共体背景下宁夏P县县域医务人员流动意向及影响因素研究OA

Objective To explore the current status of medical staff's turnover intention in the context of compact county-level medical communities,identify the key push,pull,and mooring factors based on the Push-Pull-Mooring(PPM)model,and provide empirical evidence for stabilizing the grassroots medical workforce.Methods A survey and qualitative interviews were con-ducted among 591 medical staff in the medical communities of P County in Ningxia.Their turnover intention was measured using the Mobley Turnover Intention Scale.Data were analyzed using SPSS 26.0 with t-tests,ANOVA,Pearson correlation,and mul-tiple linear regression.Results Linear regression showed that workload had a significantly positively predictive effect on turnover intention,while salary satisfaction,emotional belonging,social identity and development,and team atmosphere had significantly negatively predictive effects.Although organizational support and career development were correlated with turnover intention,their independent predictive effects disappeared after emotional belonging and social identity and development were entered into the re-gression.Interviews revealed that excessive administrative workload and lack of competitive salary at the grassroots level were the main drivers of turnover.Conclusion In the context of county-level medical communities,external policy environment and social identity constitute a"structural mooring force"that transcends the management of a single medical institution when intervening in medical staff's turnover intention.The current low turnover rate may mask"passive retention",and caution is needed against the risk of"the capable leaving while the passive staying".Organizational support and career development need to leverage emotional belonging and social identity to better exert their mooring effects.It is recommended to shift from"institution-based retention"to"system-based retention",strengthen external recognition and emotional ties through the county medical community,implement differentiated interventions for high-risk groups,and build a sustainable grassroots health talent ecosystem.