关键词: 乡村医生；离职意向；厌倦, 职业性；影响因素分析

Abstract: Objective　To explore the turnover intention and its influencing factors among the village doctors in central China，providing a scientific basis for stabilizing village doctors workforce.Methods　This cross-sectional survey was conducted from November 2016 to April 2017 in 991 village clinics of 27 counties（districts） of 8 provinces in central China participating the project named "The China PEACE（Patient-centered Evaluative Assessment of Cardiac Events）MPP（Million Persons Project）".All on-the-job village doctors from the clinics took part in the survey to answer a self-developed questionnaire consisting of demographic characteristics，length of service，service content，phased training，actual-to-expected wage ratio，insurance，job burnout and turnover intention.A total of 1 669 participants returned responsive questionnaires.Two-level Logistic regression models were used to analyze the influencing factors of turnover intention.Results　The overall prevalence of turnover intention was 34.03%（568/1 669）.Univariate analysis revealed that the prevalence of turnover intention differed significantly by sex，age，service length，phased training，actual-to-expected wage ratio，insurance，emotional exhaustion，depersonalization，and low personal accomplishment（P<0.05） but not by minzu，educational level，major，professional and title and service content（P>0.05）.Two-level Logistic regression analysis showed that the low actual-to-expected wage ratio（0-，OR=20.738；20%-，OR=6.101；40%-，OR=5.657；60%-，OR=4.457），lack of insurance（OR=1.769），high level of job burnout（severe emotional exhaustion，OR=2.436；severe depersonalization，OR=1.626；moderate depersonalization，OR=1.486；lowest personal accomplishment，OR=1.948） were associated with a higher prevalence of turnover intention（P<0.05）.Conclusion　High prevalence of turnover intention among village doctors in central China was found，which was associated with actual-to-expected wage ratio，insurance and job burnout.In order to stabilize and develop the village doctors workforce，the salary of them should be improved by well implementing the policies about incentive and guaranteed compensations.

Key words: Rural doctors；Turnover intention；Burnout, professional；Root cause analysis