医疗卫生服务体系整合型改革对医务人员工作动机及行为影响的系统综述

The adjustment of policies and systems at all levels in The construction of integrated medical and health service system means the change of working environment as well as the incentive factors obtained from the environment, while to a certain extent ,the continuity and performance depend on the working motivation of medical works. Objective: To explore the changes of work motivation and behavior of health service providers during the construction and implementation of integrated medical and health service system. Methods: Systematic review method was used to retrieve and screen the literatures, thematic synthesis method was adopted to extract the literatures information, and then we analyzed the influence mechanism of work motivation based on ERG theory. Results: The 19 included studies found integrated reform had met different levels of the medical workers,influencing job satisfaction, job burnout and job stress positively. But every integrated pattern had relative lag compensation system, that was income cannot compensate for the negative effects of increased workload and work pressure. Conclusion: In the process of integrated reform, attention should be paid to the influence of the incentive factors. It is recommended to focus on the coordination of policy within and between integration, change the traditional income structure o, optimize the operating environment and resource acquisition, create a career path in both horizontally and vertically, specially pay attention on the role of primary health care institutions and their medical personnel, and extend the connotation of family doctor team.