Job preferences of Chinese primary health care workers: A discrete choice experiment.

IF 1.9 4区医学 Q3 HEALTH POLICY & SERVICES

Journal of Health Services Research & Policy Pub Date : 2024-04-01 Epub Date: 2023-12-18 DOI:10.1177/13558196231219386

Yingxi Lin, Jinfeng Xie, Dan Wu, Yingyu Wang, Yiyuan Cai, Qing Zhao, Lanping Zhang, Jiaqi Li, Wenjun He, Dong Roman Xu

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引用次数: 0

Abstract

Objective: Primary health workers (PHWs) are a critical pillar of health systems but primary health care centers often struggle to attract and retain talented staff. To better understand why this is, we investigated the job preference of PHWs in a Chinese urban setting.

Methods: In a discrete choice experiment, PHWs from 15 primary health care centers in Guangzhou, China, made trade-offs between several hypothetical job scenario combinations of salary, type of health institution, bianzhi (permanent post), work years required for promotion, career development and training opportunities, educational opportunities for children, and community respect. Based on the estimate of the mixed logit model, willingness to pay and policy simulations were applied to estimate the utility of each attribute.

Results: Data were collected from 446 PHWs. The PHWs were willing to forgo Chinese Renminbi 2806.1 (US$ 438.5) per month to obtain better education opportunities for their children, making it the most important non-monetary factor. Their preferences were also influenced relatively more by salary, bianzhi, and community respect, than with the other attributes we tested for, work years required for promotion, career development and training opportunities, and type of health institution.

Conclusion: Salary is a robust predictive factor, while three non-monetary factors (opportunities for children's education, bianzhi, and community respect) are essential in retaining health workers in primary care.

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中国基层医疗工作者的工作偏好：离散选择实验。

目标：初级卫生保健人员（PHW）是卫生系统的重要支柱，但初级卫生保健中心往往难以吸引和留住优秀人才。为了更好地理解这一原因，我们调查了中国城市基层卫生工作者的工作偏好：在离散选择实验中，来自中国广州 15 家基层医疗卫生机构的卫生保健人员在工资、医疗机构类型、长期职位、晋升所需工作年限、职业发展和培训机会、儿童教育机会以及社区尊重等几种假设的工作情景组合之间进行了权衡。根据混合对数模型的估计值，应用支付意愿和政策模拟来估计每个属性的效用：结果：收集了 446 名公共卫生工人的数据。为了让子女获得更好的教育机会，家庭主妇愿意每月放弃 2806.1 元人民币（438.5 美元），这是最重要的非货币因素。与我们测试的其他属性、晋升所需的工作年限、职业发展和培训机会以及医疗机构类型相比，工资、扁担和社区尊重对他们的偏好影响相对更大：结论：工资是一个强有力的预测因素，而三个非货币因素（子女教育机会、乡贤和社区尊重）则是留住基层医疗卫生人员的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Health Services Research & Policy HEALTH POLICY & SERVICES-

CiteScore

4.40

自引率

4.20%

发文量

期刊介绍： Journal of Health Services Research & Policy provides a unique opportunity to explore the ideas, policies and decisions shaping health services throughout the world. Edited and peer-reviewed by experts in the field and with a high academic standard and multidisciplinary approach, readers will gain a greater understanding of the current issues in healthcare policy and research. The journal"s strong international editorial advisory board also ensures that readers obtain a truly global and insightful perspective.