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Mapulanga M, Kgarosi K, Maluleke K, Hlongwa M, Dlungwane T. Evidence of community health workers' delivery of physical rehabilitation services in sub-Saharan Africa: a scoping review. BMJ Open 2024; 14:e079738. [PMID: 38816054 PMCID: PMC11141183 DOI: 10.1136/bmjopen-2023-079738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 05/20/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVES To map the evidence and scope of physical rehabilitation services delivered by community health workers (CHWs) in sub-Saharan Africa (SSA). DESIGN Scoping review DATA SOURCES: PubMed, Scopus, Cochrane Central and databases within the EBSCOhost platform. We also searched other literature sources including reference lists, conference presentations and organisational websites such as WHO, Ministries of Health and non-governmental organisations in SSA. ELIGIBILITY CRITERIA FOR SELECTION OF STUDIES Articles presenting evidence on CHWs' delivery of physical rehabilitation services in SSA from September 1978 to June 2023. DATA EXTRACTION AND SYNTHESIS Screening was conducted by two reviewers and was guided by the inclusion criteria. Thematic content analysis of data was employed. The results are presented according to the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews. RESULTS A total of 6996 articles were identified through various databases, with only 20 studies qualifying for data extraction. Evidence was presented by Eritrea, Ethiopia, Malawi, Mauritius, Namibia, South Africa and Uganda. Assessments, case management, health education, community liaison with support, health systems linkage and administration were the CHWs' scope of practice identified. The review identified home-based, community-based, community and facility-based, home and community-based and facility-based as modes of delivery. The barriers experienced are resources, societal and community attitudes, governance, geographical barriers and delivery capacity, while proximity to the community, positive job attitude and support with collaboration facilitated service delivery. CONCLUSION Training and integrating CHWs in national health care systems, with careful selection of existing CHWs, would minimise the barriers faced.
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Affiliation(s)
- Miriam Mapulanga
- Discipline of Public Health, School of Nursing and Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, KZN, South Africa
- Research Unit, Lusaka Environmental Health University, Lusaka, Zambia, Zambia
| | - Kabelo Kgarosi
- Department of Library Services, Faculty of Health Sciences University of Pretoria, Pretoria, South Africa
| | - Kuhlula Maluleke
- School of Health Systems and Public Health, Faculty of Health Sciences University of Pretoria, Pretoria, Gauteng, South Africa
| | - Mbuzeleni Hlongwa
- Discipline of Public Health, School of Nursing and Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, KZN, South Africa
- Public Health, Societies and Belonging, Human Sciences Research Council, Pretoria, South Africa
| | - Thembelihle Dlungwane
- Discipline of Public Health, School of Nursing and Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, KZN, South Africa
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Xiong Y, Lin K, Yao Y, Zhong Z, Xiang L. Comparison of the market share of public and private hospitals under different Medical Alliances: an interrupted time-series analysis in rural China. BMC Health Serv Res 2024; 24:496. [PMID: 38649910 PMCID: PMC11034031 DOI: 10.1186/s12913-024-10941-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND China initiated the Medical Alliances (MAs) reform to enhance resource allocation efficiency and ensure equitable healthcare. In response to challenges posed by the predominance of public hospitals, the reform explores public-private partnerships within the MAs. Notably, private hospitals can now participate as either leading or member institutions. This study aims to evaluate the dynamic shifts in market share between public and private hospitals across diverse MAs models. METHODS Data spanning April 2017 to March 2019 for Dangyang County's MA and January 2018 to December 2019 for Qianjiang County's MA were analyzed. Interrupted periods occurred in April 2018 and January 2019. Using independent sample t-tests, chi-square tests, and interrupted time series analysis (ITSA), we compared the proportion of hospital revenue, the proportion of visits for treatment, and the average hospitalization days of discharged patients between leading public hospitals and leading private hospitals, as well as between member public hospitals and member private hospitals before and after the reform. RESULTS After the MAs reform, the revenue proportion decreased for leading public and private hospitals, while member hospitals saw an increase. However, ITSA revealed a notable rise trend in revenue proportion for leading private hospitals (p < 0.001), with a slope of 0.279% per month. Member public and private hospitals experienced decreasing revenue proportions, with outpatient visits proportions declining in member public hospitals by 0.089% per month (p < 0.05) and inpatient admissions proportions dropping in member private hospitals by 0.752% per month (p < 0.001). The average length of stay in member private hospitals increased by 0.321 days per month after the reform (p < 0.01). CONCLUSIONS This study underscores the imperative to reinforce oversight and constraints on leading hospitals, especially private leading hospitals, to curb the trend of diverting patients from member hospitals. At the same time, for private hospitals that are at a disadvantage in competition and may lead to unreasonable prolongation of hospital stay, this kind of behavior can be avoided by strengthening supervision or granting leadership.
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Affiliation(s)
- Yingbei Xiong
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, 430030, Wuhan, China
| | - Kunhe Lin
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, 430030, Wuhan, China
| | - Yifan Yao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, 430030, Wuhan, China
| | - Zhengdong Zhong
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, 430030, Wuhan, China
| | - Li Xiang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, 430030, Wuhan, China.
- HUST base of National Institute of healthcare Security, Wuhan, China.
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Li C, Meng X. Effective analysis of job satisfaction among medical staff in Chinese public hospitals: a random forest model. Front Public Health 2024; 12:1357709. [PMID: 38699429 PMCID: PMC11063264 DOI: 10.3389/fpubh.2024.1357709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/05/2024] [Indexed: 05/05/2024] Open
Abstract
Objective This study explored the factors and influence degree of job satisfaction among medical staff in Chinese public hospitals by constructing the optimal discriminant model. Methods The participant sample is based on the service volume of 12,405 officially appointed medical staff from different departments of 16 public hospitals for three consecutive years from 2017 to 2019. All medical staff (doctors, nurses, administrative personnel) invited to participate in the survey for the current year will no longer repeat their participation. The importance of all associated factors and the optimal evaluation model has been calculated. Results The overall job satisfaction of medical staff is 25.62%. The most important factors affecting medical staff satisfaction are: Value staff opinions (Q10), Get recognition for your work (Q11), Democracy (Q9), and Performance Evaluation Satisfaction (Q5). The random forest model is the best evaluation model for medical staff satisfaction, and its prediction accuracy is higher than other similar models. Conclusion The improvement of medical staff job satisfaction is significantly related to the improvement of democracy, recognition of work, and increased employee performance. It has shown that improving these five key variables can maximize the job satisfaction and motivation of medical staff. The random forest model can maximize the accuracy and effectiveness of similar research.
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Affiliation(s)
| | - Xuehui Meng
- Department of Health Service Management, Humanities and Management School, Zhejiang Chinese Medical University, Hangzhou, China
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Alvarez-Peregrina C, Garcia de la Noceda A, Martinez-Perez C, Sánchez-Tena MÁ. Job satisfaction of Spanish and Portuguese optometrists. JOURNAL OF OPTOMETRY 2024; 17:100492. [PMID: 38171112 PMCID: PMC10796967 DOI: 10.1016/j.optom.2023.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE Given the increase in demand for optometry services by society and the importance of the Optometry profession in Portugal and Spain, the objective of this study was to determine job satisfaction and important factors related to this satisfaction in a sample of Portuguese and Spanish optometrists. METHODS A prospective, cross-sectional, and observational study was carried out from June to December 2021. An adaptation of the 15-item job satisfaction in eye-care personnel (JSEP) questionnaire validated by Paudel et al. was administered to Portuguese and Spanish optometrists. The questionnaire was shared through different social media (Facebook, LinkedIn, WhatsApp, etc.) in a Google form during the months of June to December 2021 in Portugal and Spain. RESULTS A total of 530 surveys were collected in Portugal (42.3%; n = 224) and Spain (57.7%; n = 306). The factors that most influence overall job satisfaction are salary, career development opportunities, recognition/prestige in society, good work-life balance (all p<0.001), workplace equipment and facilities, and encouragement reward positive feedback (both p = 0.002). When comparing the determinants of job satisfaction of optometrists, it was found that Portuguese professionals were generally more satisfied than Spanish ones (p<0.001). However, Spanish optometrists reported feeling more supported by their colleagues (p<0.001). CONCLUSION This study has shown that the level of job satisfaction was higher in Portugal than in Spain. The most important factors influencing job satisfaction were salary, job stability, and support from colleagues.
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Affiliation(s)
- Cristina Alvarez-Peregrina
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, 28037 Madrid, Spain
| | - Alejandro Garcia de la Noceda
- Faculty of Biomedical and Health Science, Universidad Europea de Madrid, 28670 Madrid, Spain; Dive Medical SL, Zaragoza, Spain
| | - Clara Martinez-Perez
- ISEC LISBOA-Instituto Superior de Educação e Ciências, 1750-179 Lisbon, Portugal
| | - Miguel Ángel Sánchez-Tena
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, 28037 Madrid, Spain; ISEC LISBOA-Instituto Superior de Educação e Ciências, 1750-179 Lisbon, Portugal.
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Liu M, Wang J, Lou J, Zhao R, Deng J, Liu Z. What is the impact of integrated care on the job satisfaction of primary healthcare providers: a systematic review. HUMAN RESOURCES FOR HEALTH 2023; 21:86. [PMID: 37915032 PMCID: PMC10619237 DOI: 10.1186/s12960-023-00874-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/27/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND AND OBJECTIVES The integration of care influenced the job satisfaction of healthcare professionals, especially affecting primary healthcare providers (PCPs). This study aimed to perform a systematic review to explore the impact of integrated care on the job satisfaction of PCPs on the basis of Herzberg's two-factor theory. METHODS This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched 6 electronic databases, including CNKI, WANFANG, PubMed, Web of Science, Cochrane Library, and Embase. Data were retrieved from inception to 19 March 2023. The Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the methodological quality of studies for inclusion in the review. RESULTS A total of 805 articles were retrieved from databases, of which 29 were included in this review. 2 categories, 9 themes, and 14 sub-themes were derived from the data. 2 categories were identified as intrinsic and extrinsic factors. Intrinsic factors included 4 themes: responsibilities, promotion opportunities, recognition, and a sense of personal achievements and growth. Extrinsic factors included 5 themes: salaries and benefits, organizational policy and administration, interpersonal relationships, working conditions, and work status. To specify some key information under certain themes, we also identify sub-themes, such as the sub-theme "workload", "work stress", and "burnout" under the theme "work status". CONCLUSIONS Findings suggested that the integration of care had both negative and positive effects on the job satisfaction of PCPs and the effects were different depending on the types of integration. Since PCPs played a vital role in the successful integration of care, their job satisfaction was an important issue that should be carefully considered when implementing the integration of care.
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Affiliation(s)
- Mei Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Jian Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| | - Jiaxu Lou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Ruonan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Jiahui Deng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Ziyu Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
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Zhang M, Li S, Han D, Wu Y, Zhao J, Liao H, Ma Y, Yan C, Wang J. Association of Job Characteristics and Burnout of Healthcare Workers in Different Positions in Rural China: A Cross-Sectional Study. Int J Public Health 2023; 68:1605966. [PMID: 37600525 PMCID: PMC10434533 DOI: 10.3389/ijph.2023.1605966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/24/2023] [Indexed: 08/22/2023] Open
Abstract
Objectives: Health workers in rural primary care systems are at increased risk of job burnout, but their associations with different positions have received scant attention in the literature. Thus, this study aims to measure job burnout in different positions in rural China and to identify factors associated with it. Methods: A cross-sectional survey was conducted with a total of 15,627 participants from six provinces in China. And job burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Scale (MBI-GS). Multilevel regression analyses were used in examining factors potentially associated with job burnout in different positions. Results: Overall, more than half of providers suffered from moderate burnout. The degree of job burnout varied among different positions. Middle managers showed higher levels personal stress, while general staff showed the lowest interpersonal and self-evaluation dimensions of burnout. Job duty, job capability, job treatment, and career advancement are potential factors affecting these results. Conclusion: Interventions aimed at providing appropriate training and development opportunities, developing relevant career planning and management strategies, and implementing reasonable staffing and job design may be promising strategies for alleviating burnout in different positions and improving health system performance.
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Affiliation(s)
- Mei Zhang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sangsang Li
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dan Han
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yunyi Wu
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jie Zhao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hui Liao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ying Ma
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chaoyang Yan
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Wang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Cantarelli P, Vainieri M, Seghieri C. The management of healthcare employees' job satisfaction: optimization analyses from a series of large-scale surveys. BMC Health Serv Res 2023; 23:428. [PMID: 37138347 PMCID: PMC10155170 DOI: 10.1186/s12913-023-09426-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/19/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Measuring employees' satisfaction with their jobs and working environment have become increasingly common worldwide. Healthcare organizations are not extraneous to the irreversible trend of measuring employee perceptions to boost performance and improve service provision. Considering the multiplicity of aspects associated with job satisfaction, it is important to provide managers with a method for assessing which elements may carry key relevance. Our study identifies the mix of factors that are associated with an improvement of public healthcare professionals' job satisfaction related to unit, organization, and regional government. Investigating employees' satisfaction and perception about organizational climate with different governance level seems essential in light of extant evidence showing the interconnection as well as the uniqueness of each governance layer in enhancing or threatening motivation and satisfaction. METHODS This study investigates the correlates of job satisfaction among 73,441 employees in healthcare regional governments in Italy. Across four cross sectional surveys in different healthcare systems, we use an optimization model to identify the most efficient combination of factors that is associated with an increase in employees' satisfaction at three levels, namely one's unit, organization, and regional healthcare system. RESULTS Findings show that environmental characteristics, organizational management practices, and team coordination mechanisms correlates with professionals' satisfaction. Optimization analyses reveal that improving the planning of activities and tasks in the unit, a sense of being part of a team, and supervisor's managerial competences correlate with a higher satisfaction to work for one's unit. Improving how managers do their job tend to be associated with more satisfaction to work for the organization. CONCLUSIONS The study unveils commonalities and differences of personnel administration and management across public healthcare systems and provides insights on the role that several layers of governance have in depicting human resource management strategies.
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Affiliation(s)
- Paola Cantarelli
- Management and Healthcare Laboratory, Institute of Management and L'EMbeDS, Sant'Anna School of Advanced Studies, Piazza Martiri Della Libertà 33, Pisa, 56127, Italy.
| | - Milena Vainieri
- Management and Healthcare Laboratory, Institute of Management and L'EMbeDS, Sant'Anna School of Advanced Studies, Piazza Martiri Della Libertà 33, Pisa, 56127, Italy
| | - Chiara Seghieri
- Management and Healthcare Laboratory, Institute of Management and L'EMbeDS, Sant'Anna School of Advanced Studies, Piazza Martiri Della Libertà 33, Pisa, 56127, Italy
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Ejigu Y, Abera N, Haileselassie W, Berhanu N, Haile BT, Nigatu F, Tewfik N, Kiflie Y, Medhin G, Walelign F, Demissie M, Tigabu S, Taddesse D, Dadi TL, Teklu A. Motivation and job satisfaction of community health workers in Ethiopia: a mixed-methods approach. HUMAN RESOURCES FOR HEALTH 2023; 21:35. [PMID: 37127695 PMCID: PMC10152586 DOI: 10.1186/s12960-023-00818-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 04/12/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Ethiopia has been providing health care to its rural population since 2004 using female Community Health Workers called Health Extension Workers (HEWs). The HEWs are credited with several achievements in improving the country's health indicators. However, information about the HEWs' motivation and job satisfaction is limited. The aim of this study was to assess the HEWs' motivation and job satisfaction, as well as the factors that influence them. METHODS A mixed-methods study was nested within a national health extension program assessment conducted from March 01 to May 31, 2019. A structured questionnaire which looked at motivation and satisfaction with Likert type single-question and multiple-item measures was used to collect quantitative data from 584 HEWs. Focus group discussion and in-depth interviews were used to gather qualitative data. Means and percentages were used to descriptively summarize important variables. Linear regression was used to identify factors associated with job satisfaction. The qualitative data was analysed thematically. RESULTS Overall, 48.6% of HEWs were satisfied with their job, with a mean score of 2.5 out of 4.0. The result showed a high level of satisfaction with autonomy (72%), relationships with co-workers (67%), and recognition (56%). Low level of satisfaction was linked to pay and benefits (13%), opportunities for promotion (29%), and education (34%). Regression analysis showed that HEWs in the age category of 30 years and older had lower satisfaction scores as compared to HEWs in the age category of 18-24 years (adjusted β = - 7.71, 95% CI: - 14.42, - 0.99). The qualitative result revealed that desire to help their community, recognition or respect gained from the community, and achievement were the major motivating factors. In contrast, inadequate pay and benefit, limited education and career advancement opportunities, workload, work environment, limited supportive supervision, and absence of opportunity to change workplace were the demotivating factors. CONCLUSIONS The overall job satisfaction of HEWs was low; extrinsic factors, such as inadequate pay, limited education and career advancement opportunities were the major sources of demotivation. Policy makers and human resource managers should revise their human resource policies and guidelines to address the main sources of low level of job satisfaction and demotivation.
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Affiliation(s)
- Yohannes Ejigu
- Faculty of Public Health, Department of Health Policy and Management, Jimma University, Jimma, Ethiopia.
- Monitoring, Evaluation, Research, and Quality Improvement (MERQ) PLC, Ethiopia Office, Addis Ababa, Ethiopia.
| | - Netsanet Abera
- School of Public Health, Hawassa University, Hawassa, Ethiopia
| | | | - Negalign Berhanu
- Faculty of Public Health, Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
| | - Biniyam Tadesse Haile
- Faculty of Public Health, Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
| | - Frehiwot Nigatu
- International Institute for Primary Health Care, Addis Ababa, Ethiopia
| | - Nurhan Tewfik
- International Institute for Primary Health Care, Addis Ababa, Ethiopia
| | - Yibeltal Kiflie
- Faculty of Public Health, Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
- Monitoring, Evaluation, Research, and Quality Improvement (MERQ) PLC, Ethiopia Office, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Monitoring, Evaluation, Research, and Quality Improvement (MERQ) PLC, Ethiopia Office, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fasil Walelign
- Monitoring, Evaluation, Research, and Quality Improvement (MERQ) PLC, Ethiopia Office, Addis Ababa, Ethiopia
- School of Public Health, Wollo University, Dessie, Ethiopia
| | - Mekdes Demissie
- Monitoring, Evaluation, Research, and Quality Improvement (MERQ) PLC, Ethiopia Office, Addis Ababa, Ethiopia
| | - Setegn Tigabu
- Monitoring, Evaluation, Research, and Quality Improvement (MERQ) PLC, Ethiopia Office, Addis Ababa, Ethiopia
| | - Daniel Taddesse
- Monitoring, Evaluation, Research, and Quality Improvement (MERQ) PLC, Ethiopia Office, Addis Ababa, Ethiopia
| | - Tegene Legese Dadi
- Monitoring, Evaluation, Research, and Quality Improvement (MERQ) PLC, Ethiopia Office, Addis Ababa, Ethiopia
- School of Public Health, Hawassa University, Hawassa, Ethiopia
| | - Alula Teklu
- Monitoring, Evaluation, Research, and Quality Improvement (MERQ) PLC, Ethiopia Office, Addis Ababa, Ethiopia
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Wang H, Zhao S, Liu Q, Wang J, Yuan B. The Association Between Financial Incentives and Job Performance Among Primary Care Providers in Six Provinces of China. Healthc Policy 2022; 15:2323-2334. [DOI: 10.2147/rmhp.s384114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
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Montuori P, Sorrentino M, Sarnacchiaro P, Di Duca F, Nardo A, Ferrante B, D’Angelo D, Di Sarno S, Pennino F, Masucci A, Triassi M, Nardone A. Job Satisfaction: Knowledge, Attitudes, and Practices Analysis in a Well-Educated Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14214. [PMID: 36361094 PMCID: PMC9656398 DOI: 10.3390/ijerph192114214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/22/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
Job satisfaction has a huge impact on overall life quality involving social relationships, family connection and perceived health status, affecting job performances, work absenteeism and job turnover. Over the past decades, the attention towards it has grown constantly. The aim of this study is to analyze simultaneously knowledge, attitudes, and practices toward job satisfaction in a general population in a large metropolitan area. The data acquired from 1043 questionnaires-administered to subjects with an average age of 35.24 years-revealed that only 30% is satisfied by his job. Moreover, among all the tested sample, 12% receive, or often receive intimidation by their superior, and 23% wake up unhappy to go to work. Marital status and having children seem to be an important factor that negatively influences job satisfaction through worst behaviours. The multiple linear regression analysis shows how knowledge is negatively correlated to practices; although this correlation is not present in a simple linear regression showing a mediation role of attitudes in forming practices. On the contrary, attitudes, correlated both to knowledge and practices, greatly affect perceived satisfaction, leading us to target our proposed intervention toward mindfulness and to improve welfare regulation towards couples with children.
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Affiliation(s)
- Paolo Montuori
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | | | - Fabiana Di Duca
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Alfonso Nardo
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Bartolomeo Ferrante
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Daniela D’Angelo
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Salvatore Di Sarno
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Francesca Pennino
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Armando Masucci
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Antonio Nardone
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
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Kim R. Predictors of Satisfaction With Work Environment in the Context of a Mismatch in Working Hours: A Nationwide, Large-Scale, Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221128239. [PMID: 36205396 PMCID: PMC9549121 DOI: 10.1177/00469580221128239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This nationwide, large-scale, cross-sectional study has hypothesized that there might be differences in workers' satisfaction with work environment depending on demographic, socio-economic, and work characteristics in the context of a mismatch between actual and preferred working hours. The current study is a secondary data analysis of the Fifth Korean Working Conditions Survey. A total of 29 694 subjects (n = 29 694) were finally included in the current study. Female gender (β = -.372, OR 0.689 [95% CI 0.646-0.736]), age of ≥60 years old (β = .226, OR 1.253 [95% CI 1.089-1.441]), graduation from middle school (β = -.320, OR 0.726 [95% CI 0.616-0.856]), college (β = .492, OR 1.636 [95% CI 1.371-1.952]), or university (β = .826, OR 2.283 [95% CI 1.918-2.718]), fixed period of work (β = -.105, OR 0.901 [95% CI 0.823-0.986]), full-time employment (β = -.105, OR 0.900 [95% CI 0.813-0.996]), the engagement in public sector (β = .544, OR 1.722 [95% CI 1.532-1.935]), private-public partnership organization (β = .605, OR 1.832 [95% CI 1.342-2.500]) or NPO or NGO (β = .780, OR 2.182 [95% CI 1.522-3.127]), regular side job (β = -.929, OR 0.395 [95% CI 0.289-0.539]), or temporary side job (β = -.330, OR 0.719 [95% CI 0.533-0.970]), membership of multiple teams (β = -.501, OR 0.606 [95% CI 0.552-0.666]), labor union (β = .143, OR 1.154 [95% CI 1.047-1.273]), and better health status (β = .977, OR 2.657 [95% CI 1.175-6.007]) were predictors of satisfaction with work environment in the context of a mismatch between actual and desired working hours. Based on the current results, it can be concluded that female gender, age of ≥60 years old, graduation from middle school, college, or university, fixed period of work, full-time employment, the engagement in public sector, private-public partnership organization or NPO or NGO, regular side job or temporary side job, membership of multiple teams, labor union, and better health status were predictors of satisfaction with work environment.
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Affiliation(s)
- Robert Kim
- Doctor CONSULT, Seoul, Korea,Robert Kim, Department of Medical and
Pharmaceutical Affairs, Doctor CONSULT, 168 Nonhyeon-ro, Gangnam-gu, Seoul
06296, Korea.
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Chen Y, You Y, Wang Y, Wang Y, Dai T. Systematic and meta-based evaluation on job satisfaction of village doctors: An urgent need for solution issue. Front Med (Lausanne) 2022; 9:856379. [PMID: 36059843 PMCID: PMC9433829 DOI: 10.3389/fmed.2022.856379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/25/2022] [Indexed: 12/12/2022] Open
Abstract
BackgroundVillage doctors are the health “gatekeepers” of rural residents in most developing countries. They undertake a series of strenuous but pivotal missions, including prevention, diagnosis, and treatment of complicated diseases, sanitation services and management, and preventive healthcare and education tasks. Hence, it is of great importance to evaluate the village doctors’ job satisfaction status, which is one of the most important indicators that can reflect the current working state, to provide guidelines for the healthcare policies.MethodsLiterature search was conducted in 7 authoritative databases, including PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure (CNKI). Experts in the field of social medicine were consulted to achieve supplement and obtain relevant literature. China was selected as a representative of the village doctor system for the in-depth analysis. Building on the previous literature, we modified and proposed a novel strategy that can transform and integrate the outcome indicators to conduct a meta-based and quantitative assessment on job satisfaction.ResultsA total of 37 publications and 23,595 village doctors were included in this research. The meta-analysis showed that the overall job satisfaction score of village doctors was 3.1858 (total score: 5.00), 95% CI: 2.9675–3.404, which represented the level of “neither satisfied nor dissatisfied.” However, in the subsequent adjustment of publication bias, this score reduced to 2.7579, 95% CI: 2.5254–2.9904, which indicated a direct “dissatisfied” level. To discover the underlying causes, a holistic analysis of each dimension and influencing factors of job satisfaction was conducted, and the results demonstrated that “Financial Rewards” (2.49) was the most important factor causing dissatisfaction among village doctors, followed by “Job Security (2.52)” and “Work Stress (3.05).” Several important themes were also identified and assessed to explore the factors related to this topic.ConclusionThis study indicated that there is an urgent need to improve the working status of health workers in rural and remote areas, especially in the middle- and low-income countries. Health policy makers should not only improve the current remuneration and subsidies of village doctors but also guide the professional development and give them more job security to enhance the work stability of this group. More specifically, in the context of the COVID-19 pandemic, further surveys on job satisfaction of village doctors should be carried out to take targeted measures.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021289139].
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Affiliation(s)
- Yuquan Chen
- Institute of Medical Information and Medical Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yanwei You
- School of Social Sciences, Tsinghua University, Beijing, China
| | - Yue Wang
- Institute of Medical Information and Medical Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yudong Wang
- Institute of Medical Information and Medical Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Tao Dai
- Institute of Medical Information and Medical Library, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Tao Dai,
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Conceptualising the Factors Influencing Community Health Workers’ Preparedness for ICT Implementation: A Systematised Scoping Review. SUSTAINABILITY 2022. [DOI: 10.3390/su14148930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
Background: Globally, community health workers (CHW) are increasingly viewed as an integral part of the health system as opposed to simply being an extension of it. Given this view, most low- or middle-income countries (LMICs) have refocused their efforts on reorganising CHW initiatives to maximise their impact. The ongoing endeavours to augment the practice of community health workers using technological solutions are characterised by as many challenges as opportunities. In low- and middle-income countries, including South Africa, information and communication technology (ICT) has become a promising development in the enhancement of the equitable coverage of health services by community health workers. However, there has not been a wide-scale implementation and adoption of ICT; most technology initiatives fail to scale up during the implementation stage, which is attributable to human and context-related factors. Although there has been an effort to develop solutions to address ICT infrastructure and technical barriers, conceptualising an evidence-based understanding of the contextual and user-related factors that influence the efficacy of technology adoption by CHWs within their multidimensional system remains critical. Objective: The purpose of the study is to conceptualise the social factors to consider when implementing a bespoke ICT solution suited to the specific demands of CHWs in primary healthcare in developing contexts, with a particular focus on the South African context. Methodology: The methodology involves synthesizing, extracting, and consolidating the findings of a systematised scoping review into concepts and factors. The review adapts Arksey and O’Malley’s scoping review approach to the study and incorporates 59 relevant articles. Results: Although the knowledge base on CHWs is extensive, there is a considerable gap in addressing structural challenges within the community system, which contributes significantly to the overall performance of CHW programs. Factors promoting policy adaptations, common practice within the health system, CHW competencies, a community’s development in terms of knowledge and economic advancement, safety and security, the environment, and the socio-cultural context all play a significant role in facilitating or impeding the success of health interventions from the individual to the national level. Conclusions: Within several practical limitations, the study shows that despite the efforts of various developing countries to promote technology adoption, the barriers to ICT adoption outweigh the benefits gained in developing countries. The paper argues that addressing these challenges before and during implementation is critical. The authors conclude with some essential concerns about assisting CHWs towards realising the desired health outcomes through ICT.
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Healthcare Professionals’ Views of the Integrated County Healthcare Consortium in Zhejiang, China. Int J Integr Care 2022; 22:25. [PMID: 35812799 PMCID: PMC9231573 DOI: 10.5334/ijic.5690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/02/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction: The integrated county healthcare consortium (ICHC) is becoming an important measure to improve the capacity of primary-level medical services and to achieve grading diagnosis and treatment system in China. However, it is not clear whether health professionals are satisfied with this reform and what are the problems with it. This study aimed to understand the satisfaction of healthcare professionals to the ICHC in Zhejiang Province, China, and analyze the problems and improvement measures of the ICHC. Methods: A cross-sectional study was carried out in the 11 pilot counties (cities and districts) implementing the construction of the ICHC in Zhejiang in November 2019. Healthcare professionals from the leading county-level hospital, three township health centers (THCs) or community health centers (CHCs) in each ICHC were invited to participate in this survey. Results: A total of 3531 healthcare professionals were included, 85.92% of the participants agreed that the integration of the Centers for Disease Control and Prevention (CDC) and other professional public health institutions into the construction of ICHC could actively promote basic public health work. The most severe problem was the lack of financial guarantee fund input (severity score: 2.92 ± 1.76). The most crucial measure to promote the construction of the ICHC was to increase government financial input and improve the security mechanism (importance score: 4.81 ± 0.47). The satisfaction of the healthcare professionals to the ICHC was 89.41%. The satisfaction of healthcare professionals from county-level hospitals was 2.37 (95% CI: 1.760–3.238) times higher than that of healthcare professionals from the township health centers (THCs) or community health centers (CHCs). The satisfaction of health professionals with a college degree or below was 3.215 (95% CI: 1.413–6.786) times higher than that of health professionals with a master’s degree or above. Conclusions: Zhejiang Province has taken adequate measures to promote the construction of the ICHC. However, there are still some problems. Appropriate and effective policies should be implemented to enhance policy coordination and promote competition among ICHCs, as well as to strengthen medical service quality management and improve performance appraisal scheme.
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Rizvi Jafree S, Khawar A, Momina AU, Khalid Mahmood Q. Infection preparedness of community health workers: implications for maternal and neonatal health services in Pakistan. Prim Health Care Res Dev 2022; 23:e27. [PMID: 35499097 PMCID: PMC9112673 DOI: 10.1017/s1463423622000081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 08/14/2021] [Accepted: 01/14/2022] [Indexed: 11/25/2022] Open
Abstract
AIM This study aimed to (i) identify community health workers' (CHWs) perceived satisfaction for maternal and neonatal health services, with respect to (1) socio-demographic characteristics; (2) coronavirus preparedness; (3) coronavirus responsiveness; and (4) employee satisfaction and (ii) investigate the interplay among study variables to identify the role of direct effects and mediation. BACKGROUND Women CHWs are salient providers for maternal and neonatal services at the primary level, especially in conservative regions. Service delivery is a valuable indicator for mother and newborn wellbeing. There is need for empirical evidence to understand how CHWs may be supported in delivering maternal and neonatal health services during pandemics. METHODS Bivariate regression was used to identify the lower odds for CHWs' perceived satisfaction for maternal and neonatal health services. In addition, structural equation modeling was used to investigate if coronavirus responsiveness and employee satisfaction as mediating variables influence the relationship between coronavirus preparedness and maternal and neonatal health services. Data were collected telephonically from 350 CHWs. The sample was representative of 35 districts of Punjab, which is the most populated province in the country. FINDINGS We found thirty predictors with respect to coronavirus preparedness, coronavirus responsiveness and employee satisfaction which contribute to lower odds of satisfaction for maternal and neonatal health services. We also found that coronavirus preparedness has a direct effect on maternal and neonatal health service satisfaction (β = .242, P < .001) and an indirect effect on maternal health satisfaction (β = .242, P < .001) via the mediation of employee satisfaction. We conclude with four critical recommendations to support CHWs in delivering optimal services, comprising of education and training, operational support, public acceptance, and employee support and benefits. The findings are important for the planning of primary health services and governance support for CHWs and poor women clients in Pakistan and other developing countries.
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Affiliation(s)
- Sara Rizvi Jafree
- Department of Sociology, Forman Christian College University, Lahore, Pakistan
| | - Amna Khawar
- Department of Psychology, Lahore College of Women University, Lahore, Pakistan
| | - Ain ul Momina
- Institute of Public Health, King Edward Medical University
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Jia H, Yu X, Jiang H, Yu J, Cao P, Gao S, Shang P, Qiang B. Analysis of factors affecting medical personnel seeking employment at primary health care institutions: developing human resources for primary health care. Int J Equity Health 2022; 21:37. [PMID: 35300695 PMCID: PMC8929258 DOI: 10.1186/s12939-022-01638-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The serious shortage of human resources for primary health care (PHC) is a common issue in health reforms worldwide. China has proposed that it is an effective way to encourage and guide qualified medical personnel to work in primary health care institutions (PHCIs). However, few studies have been conducted on the willingness and influencing factors of medical personnel to seek employment at PHCIs. METHODS Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PHCIs from the perspective of guided objects. Through a three-phase investigation of 1160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors. RESULTS A total of 6 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of PHCIs and SG. The values of the fit index indicated an acceptable-fitting model. CONCLUSION Family, remuneration, individual development, and job responsibility are closely related to the willingness of medical personnel to seek employment at PHCIs, and the internal and external environment of PHCIs is also an important factor. Therefore, the development of PHC providers can be promoted by paying attention to the family members of medical personnel, establishing a reasonable remuneration system, providing suitable development opportunities, arranging work rationally and improving the internal construction of PHCIs.
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Affiliation(s)
- Huanhuan Jia
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Xihe Yu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China.
| | - Hairui Jiang
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Jianxing Yu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Peng Cao
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Shang Gao
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Panpan Shang
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Bayuzhen Qiang
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
- Lhasa People's Hospital, Lhasa City, Tibet Autonomous Region, China
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Factors Influencing Medical Personnel to Work in Primary Health Care Institutions: An Extended Theory of Planned Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052785. [PMID: 35270475 PMCID: PMC8910718 DOI: 10.3390/ijerph19052785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/17/2022]
Abstract
In China, the primary health care institutions (PHCIs) have difficulty winning the trust of residents because of the shortage of medical personnel and the low level of skills. The government has advocated encouraging qualified doctors to work in PHCIs, but no obvious results are achieved. Based on the theory of planned behavior (TPB), this paper explores the factors affecting medical personnel seeking employment in PHCIs and then putting forward measures to improve the human resources construction of PHCIs. A three-stage survey was conducted to obtain the factors and a structural equation modeling (SEM) was applied to examine the relationship of the factors. We found that the factors affecting medical personnel to work in PHCIs include the specific conditions and work contents of PHCIs, as well as the family life and regional factors. Besides, there is a significant correlation and indirectness between these factors. Therefore, targeted measures can be proposed to improve the intention of medical personnel seeking employment in PHCIs. This study provides theoretical support for encouraging medical personnel to work in PHCIs and improving the primary health care system.
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Maharani C, Rahayu SR, Marx M, Loukanova S. The National Health Insurance System of Indonesia and primary care physicians' job satisfaction: a prospective qualitative study. Fam Pract 2022; 39:112-124. [PMID: 34173651 DOI: 10.1093/fampra/cmab067] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The implementation of the National Health Insurance System (NHIS) in Indonesia has been changing the primary care physician (PCP) work condition and their job satisfaction. OBJECTIVE This research aimed to explore the reasons behind PCPs' satisfaction and dissatisfaction with job satisfaction's aspect under the NHIS reform. METHODS We conducted an exploratory qualitative study within two areas in Central Java, Indonesia, using semi-structured in-depth interviews with 34 PCPs and 19 triangulation sources. We conducted both inductive and deductive analyses by the NVivo 11. RESULTS Most PCPs felt dissatisfied with the following aspects of the NHIS: referral system, NHIS health services standard, NHIS programmes, performance evaluation and pay-for-performance, relationship with patient and workloads. PCPs felt constrained with the referral regulation and non-specialist diagnoses, which led to dissatisfaction with performance evaluation and the pay-for-performance implementation. Furthermore, an increase in workload and conflict with patients resulted from patients' misunderstanding the NHIS health service procedures. However, PCPs felt satisfied with the chronic disease management programme and patients' appreciation. CONCLUSIONS This study presents the reasons behind PCPs' satisfaction and dissatisfaction with job satisfaction's aspect under the NHIS reform. There is a need for additional discussion among all stakeholders (Ministry of Health, Social Security Agency for Health/SSAH, primary health care and physician's professional organizations about the non-specialist diagnoses list, performance evaluation and pay-for-performance). The government and SSAH need to improve the communication and socialization of the NHIS procedures/regulations.
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Affiliation(s)
- Chatila Maharani
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany.,Department of Public Health, Universitas Negeri Semarang, Semarang, Indonesia
| | - Sri Ratna Rahayu
- Department of Public Health, Universitas Negeri Semarang, Semarang, Indonesia
| | - Michael Marx
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Svetla Loukanova
- Department of General Practice and Implementation Research, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
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Yuan B, Yu Y, Zhang H, Li H, Kong C, Zhang W. Satisfaction of Township Hospitals Health Workers on How They Are Paid in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211978. [PMID: 34831735 PMCID: PMC8618711 DOI: 10.3390/ijerph182211978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Township Hospitals (THs) are crucial providers in China's primary health delivery system. Low job satisfaction of THs health workers has been one of biggest challenges to strengthening the health system in China. Even huge amounts of studies confirmed low remuneration level as a key demotivating factor though few studies have explored the feelings of health workers on how they were paid. OBJECTIVE To analyze how the key design of Performance-based Salary System (PBS) influences the satisfaction of health workers on the payment system in China's THs. METHOD A cross-sectional study was conducted in 47 THs in Shandong China, and a total of 1136 participants were recruited. Expectancy theory was applied to design the measurements on designs of PBS. The associations between PBS design and satisfaction of health workers were analyzed by logistic regression. RESULTS Three key components of PBS design were all related to the satisfaction of health workers. Those health workers who were aware of assessment methods were more likely to be satisfied with how they were paid (OR = 2.44, p < 0.001) compared with those being not aware of the methods. The knowledge on personal performance was also associated with being satisfied (OR = 3.34, p < 0.001). The percentage of floating income in total income was negatively associated with the satisfaction, and one percentage point increase in floating income proportion could result in the possibility of being satisfied decreasing by 2.82% (95%CI -4.9 to -0.7, p = 0.01). Subgroup analysis found that only in those with lower value on monetary income, the negative influence of more floating income was significant. CONCLUSIONS When policymakers or managers apply performance-related payment to incentivize certain work behavior, they should pay attention to the design details, including keeping transparency in the performance assessment criteria, clear performance feedback, and setting the proportion of the performance-related part based on the preference of health workers in certain cultural settings.
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Affiliation(s)
- Beibei Yuan
- China Center for Health Development Studies, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
- Correspondence: ; Tel.: +86-186-1829-5166
| | - Yahang Yu
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Y.Y.); (C.K.); (W.Z.)
| | - Hongni Zhang
- School of College Industry & Commerce, Shandong Management University, 3500 Dingxiang Road, Changqing District, Jinan 250357, China;
| | - Huiwen Li
- China Population and Development Research Center, Beijing 100191, China;
| | - Chen Kong
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Y.Y.); (C.K.); (W.Z.)
| | - Wei Zhang
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Y.Y.); (C.K.); (W.Z.)
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Wei W, Gan M, Liu Y, Yang M, Liu J. Mediating effects of nurses 'personal and organizational values between organizational commitment and turnover: Cross-sectional study. PLoS One 2021; 16:e0258387. [PMID: 34648546 PMCID: PMC8516302 DOI: 10.1371/journal.pone.0258387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/26/2021] [Indexed: 12/20/2022] Open
Abstract
Background The values of individuals and organizations are the core factors driving and guiding nurses’ decision-making and actions. Previous studies mainly focused on the impact of organizational commitment and other influencing factors on turnover intention. Aim To explore the mediating effect of personal and organizational values matching the relationship between organizational commitment and turnover intention of nursing staff. Methods A cross-sectional survey of 490 subjects in four tertiary hospitals in Tianjin was conducted by convenient sampling. Multivariate regression analysis and structural equation models were used to test each hypothesis. Results The results showed that there is a negative correlation between personal and organizational values, organizational commitment and turnover intention, and personal and organizational values played an indirect intermediary role between organizational commitment and turnover intention. Conclusions Organizational commitment reduces nurses’ turnover intention indirect through personal and organizational values paths. Leaders can improve nurses’ values as members of the organization, so as to participate in their own work more actively. Implications for nursing management Managers should effectively reduce the turnover rate and stabilize the nursing team by improving the organizational commitment and personal and organizational values of clinical nurses.
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Affiliation(s)
- Wentong Wei
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Mengxin Gan
- Nursing Department, Tianjin Union Medical Center Nankai University Affiliated Hospital, Tianjin, China
| | - Yanhui Liu
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- * E-mail: (YL); (JL)
| | - Mengyu Yang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jingying Liu
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- * E-mail: (YL); (JL)
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Mertala SM, Kanste O, Keskitalo-Leskinen S, Juntunen J, Kaakinen P. Job Satisfaction among Occupational Therapy Practitioners: A Systematic Review of Quantitative Studies. Occup Ther Health Care 2021; 36:1-28. [PMID: 34407737 DOI: 10.1080/07380577.2021.1964146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A comprehensive description of the factors associated with job satisfaction among occupational therapy practitioners is needed to promote their work well-being. This systematic review aimed to describe occupational therapy practitioners' job satisfaction and the related intra-, inter-, and extra-personal factors. Original peer-reviewed studies published between 2010 and 2019 were retrieved from four databases with the review including fourteen studies. The review was conducted according to the Joanna Briggs Institute guideline. The data were analyzed by narrative synthesis. Occupational therapy practitioners experienced high job satisfaction. Job satisfaction was found to be associated with significantly lower rates of turnover intention and higher rates of rewards. The relationships between job satisfaction, professional identity, exhaustion, and social environment showed conflicting results.
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Affiliation(s)
- Sanna-Maria Mertala
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Outi Kanste
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | | | - Jonna Juntunen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Pirjo Kaakinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
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22
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Yan H, Sang L, Liu H, Li C, Wang Z, Chen R, Ding H, Hu Z, Chen G. Mediation role of perceived social support and burnout on financial satisfaction and turnover intention in primary care providers: a cross-sectional study. BMC Health Serv Res 2021; 21:252. [PMID: 33740964 PMCID: PMC7980677 DOI: 10.1186/s12913-021-06270-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/10/2021] [Indexed: 12/14/2022] Open
Abstract
Background Turnover intention is a major cause of reduced team morale and low work efficiency. It hinders work performance and reduces the quality of medical services. This study aimed to investigate the relationship between financial satisfaction and turnover intention and its mediators among primary care providers. Methods Multi-stage random cluster sampling was used to select 1241 participants from four counties and three districts in Anhui province, China. Data were collected using a self-administered questionnaire. Turnover intention was assessed with a turnover intention assessment scale. Perceived social support and burnout were measured with the 12-item Perceived Social Support Scale and the Chinese version of the Maslach Burnout Inventory, respectively. Structural equation modeling was used for data analysis. Results The findings showed high turnover intention among primary care providers (mean score 14.16 ± 4.337), and most providers reported low financial satisfaction (mean score 2.49 ± 0.990). The mean perceived social support score was 64.93 ± 13.229, and only 6.1% of primary care providers reported no burnout. Compared with participants with high financial satisfaction, those with low financial satisfaction were more likely to report higher turnover intention (β = − 0.216, p < 0.001), less perceived social support (β = 0.181, p < 0.001), and more severe burnout (β = − 0.123, p < 0.05). Turnover intention may be related to perceived social support (β = − 0.147, p < 0.001) and burnout (β = 0.239, p < 0.001). Furthermore, the effect of financial satisfaction on turnover intention was significantly mediated by perceived social support (β = − 0.027, p < 0.001) and burnout (β = − 0.029, p < 0.05). Conclusions Turnover intention is associated with financial satisfaction, with this association mediated by perceived social support and burnout. A reasonable mechanism needs to be established to improve financial satisfaction and perceived social support and reduce burnout among primary care providers.
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Affiliation(s)
- Huosheng Yan
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei, 230032, China
| | - Lingzhi Sang
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei, 230032, China
| | - Hongzhang Liu
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei, 230032, China
| | - Cancan Li
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei, 230032, China
| | - Zijing Wang
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei, 230032, China
| | - Ren Chen
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei, 230032, China
| | - Hong Ding
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei, 230032, China
| | - Zhi Hu
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei, 230032, China.
| | - Guimei Chen
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei, 230032, China.
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Jia H, Cao P, Yu J, Zhang J, Jiang H, Zhao Q, Yu X. A New Perspective for Improving the Human Resource Development of Primary Medical and Health Care Institutions: A Structural Equation Model Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2560. [PMID: 33806526 PMCID: PMC7967509 DOI: 10.3390/ijerph18052560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 11/29/2022]
Abstract
In some countries, including China, primary health care is rarely utilized because of medical personnel shortages at primary medical and health care institutions (PMHCIs). Several studies suggest that the most effective solution is to guide qualified doctors and medical graduates to work in PMHCIs, but the studies and measures have been formulated only from the perspective of the government and PMHCIs; few have considered the subjective willingness of medical personnel. Therefore, it is necessary to explore the measures to develop human resources of PMHCIs from the guiding object. This research was divided into two parts based on implicit theory and a lexical approach. The first part collected the factors affecting their choosing PMHCIs for employment, and the second part used exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modeling (SEM) to explore the dimensions and paths of the influencing factors. At last, seven factors were obtained from the EFA, and the SEM hypothesis fit the data well. Internal Organization Development, Patient Factor, Remuneration and Development, and Family Support had a significantly positive effect on the Sense of Gain of medical personnel seeking employment at PMHCIs, whereas both Job Responsibilities and Condition of the City Where the PMHCI Is Located had no significant effect. In addition, the indirect effects of Internal Organization Development and Condition of the City Where the PMHCI Is Located on the Sense of Gain were significant. The Patient Factor, Family Support, and Remuneration and Development significantly mediated the relationship between the internal and external environment of the institution and the Sense of Gain, whereas the mediating effect of Job Responsibilities was not significant. The improvement of family support, remuneration and development, and patient factors increase the willingness of medical personnel to seek employment at PMHCIs. In addition, the internal and external environments of a PMHCI play a vital role in guiding medical personnel to PMHCIs for employment. This research provides theoretical support for improving the development of human resources, guiding medical personnel to work in PMHCIs, and promoting the use of primary care services.
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Affiliation(s)
- Huanhuan Jia
- School of Public Health, Jilin University, Changchun 130000, China; (H.J.); (P.C.); (J.Y.); (J.Z.); (H.J.)
| | - Peng Cao
- School of Public Health, Jilin University, Changchun 130000, China; (H.J.); (P.C.); (J.Y.); (J.Z.); (H.J.)
| | - Jianxing Yu
- School of Public Health, Jilin University, Changchun 130000, China; (H.J.); (P.C.); (J.Y.); (J.Z.); (H.J.)
| | - Jingru Zhang
- School of Public Health, Jilin University, Changchun 130000, China; (H.J.); (P.C.); (J.Y.); (J.Z.); (H.J.)
| | - Hairui Jiang
- School of Public Health, Jilin University, Changchun 130000, China; (H.J.); (P.C.); (J.Y.); (J.Z.); (H.J.)
| | - Qize Zhao
- Jilin Province Healthcare Security Administration Management Center, Changchun 130000, China;
| | - Xihe Yu
- School of Public Health, Jilin University, Changchun 130000, China; (H.J.); (P.C.); (J.Y.); (J.Z.); (H.J.)
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Akuffo KO, Agyei-Manu E, Kumah DB, Danso-Appiah A, Mohammed AS, Asare AK, Addo EK. Job satisfaction and its associated factors among optometrists in Ghana: a cross-sectional study. Health Qual Life Outcomes 2021; 19:12. [PMID: 33413410 PMCID: PMC7791777 DOI: 10.1186/s12955-020-01650-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background Job satisfaction describes an employee’s motivation and/or feeling of satisfaction towards his/her work. Globally, healthcare professionals’ turnover and retention play a critical role in the delivery of essential health services. In Ghana, however, little has been done to ascertain job satisfaction levels among human resources for eye-health. The objective of this study therefore was to assess job satisfaction and its associated factors among optometrists in Ghana.
Methods A cross-sectional survey was conducted among 304 registered and licensed optometrists of the Ghana Optometric Association between September 2018 and June 2019. A validated, well-structured questionnaire was used to elicit information on socio-demographic characteristics of participants and measures on job satisfaction. Scores from a five-point Likert scale was employed to examine job satisfaction and its associated factors. Linear regression analyses were used to evaluate the association between overall job satisfaction and its associated factors using Rasch logit scores. Results A total of 214 optometrists gave valid responses to the questionnaires used for the final analysis. The mean (± SD) score of the overall perception of job satisfaction among optometrists was 3.36 (± 1.00), with 74.3% of them being satisfied with their jobs. After statistical adjustment, Good work-life balance (Unstandardized co-efficient (β) = 0.288, p = 0.001), Salary (β = 0.222, p < 0.0005), Supervision (β = 0.117, p = 0.044), and Continuing Education Opportunities (β = 0.138, p = 0.017) were all significantly associated with higher levels of overall job satisfaction. Conclusions Most optometrists were satisfied with their jobs. Effective strategic planning and management of human resources for eye-health in Ghana are essential in the development of quality eye-health systems and the provision of high-quality eyecare services.
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Affiliation(s)
- Kwadwo Owusu Akuffo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Eldad Agyei-Manu
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Usher Institute for Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - David Ben Kumah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anthony Danso-Appiah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana.,University of Ghana Centre for Evidence Synthesis and Policy, School of Public Health, University of Ghana, Legon, Ghana
| | - Abubakar Sadik Mohammed
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Akosua Kesewah Asare
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - Emmanuel Kofi Addo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Ophthalmology and Visual Sciences, Moran Eye Centre, University of Utah, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA
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Zhang Z, Shi G, Li L, Bian Y. Job satisfaction among primary care physicians in western China. BMC FAMILY PRACTICE 2020; 21:219. [PMID: 33100222 PMCID: PMC7586689 DOI: 10.1186/s12875-020-01292-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/20/2020] [Indexed: 12/30/2022]
Abstract
Background There has been great shortage of primary care physicians (PCPs) in China, especially in western areas. Job satisfaction plays a great role in retaining people. The aim of this study is to investigate the job satisfaction of PCPs and associated factors in 11 provinces of western China, thus providing necessary reference values for stabilizing the primary care workforce and improving the quality of primary care services. Method A sample of 2103 PCPs working in western China were surveyed using a stratified, multistage and random sampling method in 2011. The characteristics of participants were recorded by a structured questionnaire. A multilevel model (MLM) and quantile regression (QR) were applied to assess the association between job satisfaction and possible risk factors. Results Of the 2103 doctors surveyed, the overall satisfaction score was 3.26 ± 0.68 (from 1 to 5). MLM indicated that age group, income satisfaction, unit policy approval, personal planning, career attitude, work value and patient recognition were positively correlated with job satisfaction, while turnover intention was negatively correlated with job satisfaction. QR were not completely consistent with MLM and further explored the differences in different job satisfaction score percentiles on each domains. Conclusion This study showed that the job satisfaction of PCPs in western China was not high. The MLM and QR discussed were not entirely consistent, the latter one provided more information and robust results. Measures should be taken in streamlining administration and institute decentralization, creating more opportunities for additional training, raising PCPs’ income, improving the social status of doctors and improving the relationship between doctors and patients.
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Affiliation(s)
- Zhuo Zhang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, 999078, Macau, China.,School of Health Services Management, Xi'an Medical University, Xi'an, 710021, Shaanxi, China
| | - Guoshuai Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Lingui Li
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Ying Bian
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, 999078, Macau, China. .,School of Health Services Management, Xi'an Medical University, Xi'an, 710021, Shaanxi, China.
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Realigning the provider payment system for primary health care: a pilot study in a rural county of Zhejiang Province, China. Prim Health Care Res Dev 2020; 21:e43. [PMID: 33032674 PMCID: PMC7577833 DOI: 10.1017/s1463423620000444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Aim: This work aimed to evaluate a pre/post-reform pilot study from 2015 to 2018 in a rural county of Zhejiang Province, China to realign the provider payment system for primary health care (PHC). Methods: Data were extracted from the National Health Financial Annual Reports for the 21 township health centers (THCs) in Shengzhou County. An information system was designed for the reform. Differences among independent groups were assessed using Kruskal–Wallis H-test. Dunn’s post hoc test was used for multiple comparisons. Differences between paired groups were tested by Wilcoxon signed-rank test. Two-tailed P < 0.05 indicated statistical significance. Data were processed and analyzed using R 3.6.1 for Windows. Findings: First, payments to THCs shifted from a “soft budget” to a mixed system of line-item input-based and categorized output-based payments, accounting for 17.54% and 82.46%, respectively, of total revenue in 2017. Second, providers were more motivated to deliver services after the reform; total volumes increased by 27.80%, 19.22%, and 30.31% for inpatient visits, outpatient visits, and the National Essential Public Health Services Package (NEPHSP), respectively. Third, NEPHSP payments were shifted from capitation to resource-based relative value scale (RBRVS) payments, resulting in a change in the NEPHSP subsidy from 36.41 to 67.35 per capita among the 21 THCs in 2017. Fourth, incentive merit pay to primary health physicians accounted for 38.40% of total salary, and the average salary increased by 32.74%, with a 32.45% increase in working intensity. A small proportion of penalties for unqualified products and pay-for-performance rewards were blended with the payments. The reform should be modified to motivate providers in remote areas. Conclusion: In the context of a profit-driven, hospital-centered system, add-on payments – including categorized output-based payments to THCs and incentive merit pay to primary care physicians (PCPs) – are probably worth pursuing to achieve more active and output/outcome-based PHC in China.
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Nurses' Well-Being, Health-Promoting Lifestyle and Work Environment Satisfaction Correlation: A Psychometric Study for Development of Nursing Health and Job Satisfaction Model and Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103582. [PMID: 32443758 PMCID: PMC7277543 DOI: 10.3390/ijerph17103582] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/16/2020] [Accepted: 05/17/2020] [Indexed: 11/17/2022]
Abstract
Although promoting healthy work environments to enhance staff members’ health and well-being is a growing trend, no empirical studies on such a model have been conducted in the nursing management field. The purpose of this study was to develop and validate measurement scales and a conceptual model of nurses’ well-being, health-promoting lifestyle, and work environment satisfaction (WHS). A cross-sectional survey was conducted to develop a WHS model and Nursing Health and Job Satisfaction (NHJS) scale. A total of 672 questionnaires were obtained from registered nurses by stratified random sampling for validation analysis. The percentage of total variance explained greater than 92.6%, suggesting a good ability of the scales to explain the variability in participants’ responses. The hypotheses of positive correlations among nurses’ health-promoting lifestyle, well-being, and work environment satisfaction were supported. The WHS model demonstrates the positive correlation with correlation coefficients of 0.57–0.86 among nurses’ health-promoting lifestyle, well-being, and work environment satisfaction. Nurses’ attitudes play a key role in promoting a healthy lifestyle. The most important work environment satisfaction variable for improved sense of well-being is respect from other medical staff. The findings can serve as an instrument for hospital nursing administrators to accurately assess and enhance nurses’ retention rate and health.
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Wang H, Jin Y, Wang D, Zhao S, Sang X, Yuan B. Job satisfaction, burnout, and turnover intention among primary care providers in rural China: results from structural equation modeling. BMC FAMILY PRACTICE 2020; 21:12. [PMID: 31941455 PMCID: PMC6961377 DOI: 10.1186/s12875-020-1083-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 01/08/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Low job satisfaction, severe burnout and high turnover intention are found to be prevalent among the primary care providers (PCPs) in township health centers (THCs), but their associations have received scant attention in the literature. In light of this, this study aims to examine the relationships between job satisfaction, burnout and turnover intention, and explore the predictors of turnover intention with a view to retaining PCPs in rural China. METHODS Using the multistage cluster sampling method, a cross-sectional survey was conducted in Shandong Province, China. 1148 PCPs from 47 THCs participated in this study. Job satisfaction, burnout and turnover intention were measured with a multifaceted instrument developed based on the existing literature, the Maslach Burnout Inventory and the participants' responses to a Likert item drawn from the literature, respectively. The relationships of the three factors were examined using Pearson correlation and structural equation modeling, while the predictors of turnover intention were investigated using multivariate logistic regression. RESULTS The subscale that the PCPs were most dissatisfied with was job rewards (95.12%), followed by working environment (49.65%) and organizational management (47.98%). The percentages of the PCPs reporting high-levels of emotional exhaustion, depersonalization and reduced personal accomplishment were 27.66, 6.06, and 38.74%, respectively. About 14.06% of the respondents had high turnover intention. There was a significant direct effect of job satisfaction on burnout (γ = - 0.52) and turnover intention (γ = - 0.29), a significant direct effect of burnout on turnover intention (γ = 0.28), and a significant indirect effect (γ = - 0.14) of job satisfaction on turnover intention through burnout as a mediator. Work environment satisfaction, medical practicing environment satisfaction, and organizational management satisfaction proved to be negative predictors of turnover intention (p < 0.05), whereas reduced personal accomplishment was identified as a positive predictor (p < 0.05). CONCLUSIONS Plagued by low job satisfaction and severe burnout, the PCPs in rural China may have high turnover intentions. Job satisfaction had not only negative direct effects on burnout and turnover intention, but also an indirect effect on turnover intention through burnout as a mediator. Targeted strategies should be taken to motivate and retain the PCPs.
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Affiliation(s)
- Haipeng Wang
- School of Health Care Management, Shandong University, Jinan, 250012, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Dan Wang
- China Center for Health Development Studies, Peking University, Beijing, 100191, China
| | - Shichao Zhao
- School of Public Administration, Shandong Normal University, Jinan, 250014, China
| | - Xingang Sang
- Health Commission of Weifang, Weifang, 261061, Shandong, China
| | - Beibei Yuan
- China Center for Health Development Studies, Peking University, Beijing, 100191, China.
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Gu X, Itoh K. A comparative study on healthcare employee satisfaction between Japan and China. Int J Health Plann Manage 2020; 35:171-184. [DOI: 10.1002/hpm.2859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Xiuzhu Gu
- Department of Industrial Engineering and Economics, School of EngineeringTokyo Institute of Technology Tokyo Japan
| | - Kenji Itoh
- Department of Industrial Engineering and Economics, School of EngineeringTokyo Institute of Technology Tokyo Japan
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Abstract
OBJECTIVE Although China has made remarkable progress in strengthening its primary healthcare system, lack of well-performed primary health workforce is still the bottleneck of deepening the reform. The objective of this review is to understand the current profile of Chinese primary care workers (PCWs) and their motivating factors of performance and propose targeted policy suggestions on improving their work performance. DESIGN Systematic review. METHODS A systematic search of PubMed and MEDLINE was conducted to identify articles published from January 1, 2000, to June 2, 2018. Quality assessment and data extraction for the studies closely relevant to performance of PCWs in China were conducted by two reviewers independently. A preliminary framework containing different levels of factors influencing PCWs' motivation based on existence, growth and relatedness (ERG) theory guided the synthesis analysis. In addition, we used a random-effects model to pool individual studies on job satisfaction and estimate the overall job satisfaction of PCWs. RESULTS A total of 36 articles were included; 16 (23 882 participants) in the meta-analysis. Regarding the individual level of motivation, 3 overarching themes and 12 subthemes were developed. The subthemes of financial incentives, career advancement and work itself were frequently mentioned and have more influences on PCWs' performance. Moreover, the healthcare system reform policies have inevitable and complex impacts on different levels of human needs, and then influences on the motivation and performance of PCWs. Meta-analysis showed that the overall job satisfaction score among PCWs was 3.30, just reaching a satisfied rating and varied in different regions. CONCLUSIONS This study suggests low work satisfaction among PCWs in China, with financial incentives and career advancement being two most important motivating factors. Efforts to improve the work performance in PCWs should give priority to these motivating factors and systematically take into account the health policy's impacts on performance of PCWs.
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Affiliation(s)
- Huiwen Li
- China Centre for Health Development Studies, Peking University, Beijing, China
| | - Beibei Yuan
- China Centre for Health Development Studies, Peking University, Beijing, China
| | - Dan Wang
- China Centre for Health Development Studies, Peking University, Beijing, China
| | - Qingyue Meng
- China Centre for Health Development Studies, Peking University, Beijing, China
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Huang J, Dai T. Public hospital reforms in China: the perspective of hospital directors. BMC Health Serv Res 2019; 19:142. [PMID: 30819157 PMCID: PMC6393992 DOI: 10.1186/s12913-019-3954-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 02/18/2019] [Indexed: 01/20/2023] Open
Abstract
Background To understand the attitudes and opinions of directors of large public hospitals in China on reform policies of public hospital. Method A cross-sectional survey utilizing questionnaires of the Survey of Attitudes to Public Hospital Reform by Directors was conducted in 2014. The respondents were randomly selected in 100 tertiary public hospitals in 62 cities of 31 provinces in China by stratified multistage random cluster sampling method. 178 directors and associate directors working in tertiary public hospitals were involved. Standard descriptive statistics were used to describe and summarize the data. Results The measure of increasing government subsidies ranked first in the list of concerns expressed by responders (N = 149, 83.7%); while implementing clinical pathways ranked lowest in the list of concerns (N = 34, 19.7%). More associate directors (N = 64, 70.3%) were concerned over the measures of removing drug mark-ups than directors (N = 45, 51.7%) (χ2 = 6.49, p = 0.01). In addition, 75.8% of responders were concerned over the policy of salary system reform, while only 14.5% of them were satisfied with their current income level. What’s more, more than half responders were concerned over the policy of adjusting pricing policies (N = 127, 71.4%) and removing drug markups (N = 109, 61.2%). Conclusion In healthcare reform, the financial security for the hospitals should be considered as a priority by the policy-makers, without the reform goals cannot be achieved. Thus, an incentive mechanism needs to be established in China to guide the director to focus on the medical quality.
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Affiliation(s)
- Ju Huang
- The Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), No.3 Yabao Road, Chaoyang District, Beijing, People's Republic of China, 100020
| | - Tao Dai
- The Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), No.3 Yabao Road, Chaoyang District, Beijing, People's Republic of China, 100020.
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Job Satisfaction and Associated Factors among Medical Staff in Tertiary Public Hospitals: Results from a National Cross-Sectional Survey in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071528. [PMID: 30029506 PMCID: PMC6068903 DOI: 10.3390/ijerph15071528] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 12/15/2022]
Abstract
Medical staff in China’s tertiary public hospitals are responsible for providing healthcare to a considerable number of patients, and their job satisfaction needs attention. The aim of this study is to investigate the job satisfaction of medical staff in tertiary public hospitals and to explore its associated factors. Based on a national survey conducted in 2016, this study included 43,645 physicians and nurses nested in 136 tertiary public hospitals in 31 provinces of China. Multi-level logistic regression was used to examine job satisfaction and its association with individual characteristics and job-related factors. Results showed that 48.22% respondents were satisfied with their job, and they were least satisfied with their compensation. Individual characteristics including occupation, gender, education background, alcohol drinking and self-reported health status, as well as job-related factors regarding professional title, work years, income, workload, doctor-patient relationship and practice setting were found to be significantly associated with job satisfaction. Given that some of these factors may be amenable to interventions, we suggest that government and hospital administrators could take some measures to promote continuing education, improve personal health, balance workload and compensation for medical staff, in order to improve the job satisfaction of medical staff in tertiary public hospitals.
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Provider payment to primary care physicians in China: background, challenges, and a reform framework. Prim Health Care Res Dev 2018; 20:e34. [PMID: 29618391 PMCID: PMC6536753 DOI: 10.1017/s146342361800021x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To provide a framework for provider payment reform for primary care physicians in China. Background: Primary health care is central to health system reform and payment incentives have significant consequences for the equity and efficiency of it. Methods: This paper describes the special payments system for public primary health institutions and the subsequent internal salary remuneration to primary care physicians in China. Based on an analysis of the major challenges, we suggest a reform framework including the pattern of governance, and payments to primary health institutions and employed physicians. Findings: A mixed system of input-based and output-based payments to institutions would probably be appropriate under a long-term and relational contract with the government. It was also advised that internal remuneration is provided by a basic salary plus a bonus based on performance, and an extra-regional allowance. We hope that the results can be used to shift the passive budgeting of in-house staff within the public primary health institutions toward strategic purchasing.
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Prentiss T, Zervos J, Tanniru M, Tan J. Community Health Workers (CHWs) as Innovators. INTERNATIONAL JOURNAL OF HEALTHCARE INFORMATION SYSTEMS AND INFORMATICS 2018. [DOI: 10.4018/ijhisi.2018010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Community health workers (CHWs) have a longstanding role in improving the health and well-being of underserved populations in resource-limited settings. CHWs are trusted in the communities they serve and are often able to see through solutions on community challenges that outside persons cannot. Notwithstanding, such solutions often must be low-cost, easily implementable, and permit knowledge gaps among CHWs to be filled via appropriate training. In this sense, use of cost-effective information technology (IT) solutions can be key to increasing access to knowledge for these community agents. This paper highlights insights gleaned from a pilot study performed in Detroit, Michigan with a group of CHWs in basic grant-writing training via an e-platform, the Community Health Innovator Program (CHIP). The results are discussed within the context of learning theory. It is concluded that e-platforms are necessary for CHWs to leverage knowledge from multiple sources in an adaptive environment towards addressing ever-evolving global health challenges.
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Affiliation(s)
- Tyler Prentiss
- Henry Ford Health System, Global Health Initiative, Detroit, MI, USA
| | - John Zervos
- Henry Ford Health System, Global Health Initiative, Detroit, MI, USA
| | - Mohan Tanniru
- School of Business Administration, Oakland University, Rochester, MI, USA
| | - Joseph Tan
- Professor of eHealth Informatics and eBusiness Innovation, McMaster University, Hamilton, Canada
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Li X, Lu J, Hu S, Cheng KK, De Maeseneer J, Meng Q, Mossialos E, Xu DR, Yip W, Zhang H, Krumholz HM, Jiang L, Hu S. The primary health-care system in China. Lancet 2017; 390:2584-2594. [PMID: 29231837 DOI: 10.1016/s0140-6736(17)33109-4] [Citation(s) in RCA: 563] [Impact Index Per Article: 80.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 09/23/2017] [Accepted: 10/26/2017] [Indexed: 01/10/2023]
Abstract
China has made remarkable progress in strengthening its primary health-care system. Nevertheless, the system still faces challenges in structural characteristics, incentives and policies, and quality of care, all of which diminish its preparedness to care for a fifth of the world's population, which is ageing and which has a growing prevalence of chronic non-communicable disease. These challenges include inadequate education and qualifications of its workforce, ageing and turnover of village doctors, fragmented health information technology systems, a paucity of digital data on everyday clinical practice, financial subsidies and incentives that do not encourage cost savings and good performance, insurance policies that hamper the efficiency of care delivery, an insufficient quality measurement and improvement system, and poor performance in the control of risk factors (such as hypertension and diabetes). As China deepens its health-care reform, it has the opportunity to build an integrated, cooperative primary health-care system, generating knowledge from practice that can support improvements, and bolstered by evidence-based performance indicators and incentives.
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Affiliation(s)
- Xi Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiapeng Lu
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Hu
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK; General Practice Development and Research Center, Peking University Health Science Center, Beijing, China
| | - Jan De Maeseneer
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
| | - Qingyue Meng
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Dong Roman Xu
- Sun Yat-sen Global Health Institute, Sun Yat-sen University School of Public Health, Guangzhou, Guangdong, China
| | - Winnie Yip
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Hongzhao Zhang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Harlan M Krumholz
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA
| | - Lixin Jiang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shengshou Hu
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Millar R, Chen Y, Wang M, Fang L, Liu J, Xuan Z, Li G. It's all about the money? A qualitative study of healthcare worker motivation in urban China. Int J Equity Health 2017; 16:120. [PMID: 28687089 PMCID: PMC5501304 DOI: 10.1186/s12939-017-0616-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/28/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND China's healthcare reform programme continues to receive much attention. Central to these discussions has been how the various financial incentives underpinning reform efforts are negatively impacting on the healthcare workforce. Research continues to document these trends, however, qualitative analysis of how these incentives impact on the motivation of healthcare workers remains underdeveloped. Furthermore, the application of motivational theories to make sense of healthcare worker experiences has yet to be undertaken. METHODS The purpose of our paper is to present a comparative case study account of healthcare worker motivation across urban China. It draws on semi structured interviews (n = 89) with a range of staff and organisations across three provinces. In doing so, the paper analyses how healthcare worker motivation is influenced by a variety of financial incentives; how motivation is influenced by the opportunities for career development; and how motivation is influenced by the day to day pressures of meeting patient expectations. RESULTS The experience of healthcare workers in China highlights how a reliance on financial incentives has challenged their ability to maintain the values and ethos of public service. Our findings suggest greater attention needs to be paid to the motivating factors of improved income and career development. Further work is also needed to nurture and develop the motivation of healthcare workers through the building of trust between fellow workers, patients, and the public. CONCLUSIONS Through the analysis of healthcare worker motivation, our paper presents a number of ways China can improve its current healthcare reform efforts. It draws on the experience of other countries in calling for policy makers to support alternative approaches to healthcare reform that build on multiple channels of motivation to support healthcare workers.
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Affiliation(s)
- Ross Millar
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - Yaru Chen
- Warwick Business School, University of Warwick, Coventry, UK
| | - Meng Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liang Fang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Liu
- Shihezi City People’s Hospital, Urumqi, China
| | - Zhidong Xuan
- Institute of Social Medicine and Health Management, Henan University, Kaifeng, China
| | - Guohong Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for HTA, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
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