Background: In 2002 Hospital global budget had been implemented in Taiwan. The switch from retrospective to prospective reimbursement was intended to give hospitals the incentive to be more efficient and effective. Hospitals will adapt strategically in ways and cause physician job dissatisfaction and intention to leave.
Method: Total number of 180 hospital-based physicians and are from 1 medical center and 4 regional hospitals in Tainan City. Applied 36-items survey questionnaire with 5-point Likert Scale to investigate physicians’ job satisfaction and intention to leave. Six research hypotheses derived from the proposed model were empirically validated by Structure Equation Model.
Results: The results depicted that indicates that (1) if hospital adopted more acts, physicians are more likely to perceive less job satisfaction (β = 0.770, t value = 6.192, p＜0.01). (2) Hospital strategies have a positive association with physicians’ intention to leave (β = 0.45, t value = 3.446, p＜0.01). (3) Hospital strategies are positively related to physicians’ intention to leave through job dissatisfaction (β= 0.363, t value = 4.575, p＜0.01). (4) Physician job satisfaction is negatively related to physicians’ intention to leave (β= 0.52, t value = 3.958, p＜0.01).(5) Hospital strategies, job satisfaction, and intention to leave only differ from physician’s gender and martial statuses. (6) Hospital strategies, job satisfaction, and intention to leave are no different from hospital characteristics.
Discussion: Hospital strategies such as limited prescription days and medications, and control inpatient days effect on physicians’ autonomy. These strategies have strong impact on physician job satisfaction and intention to leave their hospitals. As physician was dissatisfied, it is the most important issue for physicians’ intention to leave. Physician manpower is a quite important human resource. Thus, hospital should more focus on physicians’ job satisfaction. The limitations of this study (1) the result could not be generalized to all hospital-based physicians. (2) Only retaining physicians answered the questionnaires during the survey period so self-selection bias might exist. (3)The longitudinal studies are recommended to explore how hospital-based physicians and the relationships among research variables change over time.

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