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Homaie Rad E, Hajizadeh M, Rajabpour M, Mohtasham‐Amiri Z, Rahbar‐Taramsari M, Bahador F, Esmaeili Shoja E. Preferences of Iranian medical students for selecting the compulsory service plan packages: A discrete choice experiment. Health Sci Rep 2024; 7:e2213. [PMID: 38933426 PMCID: PMC11199194 DOI: 10.1002/hsr2.2213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/04/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
Background and Aims Health policymakers face challenges in designing compulsory plan packages for medical students to encourage them to work in disadvantaged regions. Using a discrete choice experiment, this study assessed the preferences of medical students for selecting the compulsory service plan packages in Guilan Province, Iran. Methods In total, 374 medical students responded to a survey inquiring about salary, distance from their residency city, availability of welfare amenities, work difficulty, the developmental status of their workplace, contract duration, and preference for urban or rural work settings. Results The study revealed that students favor a compulsory service package that provides higher salaries and shorter contract duration. They also show a preference for working within their home province over other factors. For the opportunity to serve in their city of residence, they would forgo an average of US$77.93 per month. Conclusion While financial incentives were the primary consideration for medical students when choosing compulsory service packages, a range of nonfinancial factors significantly influenced their decisions as well.
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Affiliation(s)
- Enayatollah Homaie Rad
- Social Determinants of Health Research Center, Trauma InstituteGuilan University of Medical SciencesRashtIran
| | - Mohamad Hajizadeh
- Canada Research Chair in Health Economics, School of Health Administration, Faculty of HealthDalhousie UniversityHalifaxCanada
| | - Mohammad Rajabpour
- Social Determinants of Health Research Center, Trauma InstituteGuilan University of Medical SciencesRashtIran
| | - Zahra Mohtasham‐Amiri
- Guilan Road Trauma Research Center, Trauma InstituteGuilan University of Medical SciencesRashtIran
| | - Morteza Rahbar‐Taramsari
- Guilan Road Trauma Research Center, Trauma InstituteGuilan University of Medical SciencesRashtIran
| | - Faezeh Bahador
- Unit of International affairsShahid Beheshti University of Medical SciencesTehranIran
| | - Ehsan Esmaeili Shoja
- Social Determinants of Health Research Center, Trauma InstituteGuilan University of Medical SciencesRashtIran
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Tozduman B, Sözmen MK. Assessing the job preferences of senior medical students for mandatory service: a discrete choice experiment. Prim Health Care Res Dev 2024; 25:e31. [PMID: 38818776 DOI: 10.1017/s1463423624000252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
AIM To investigate the job preferences of senior medical students for mandatory service as general practitioners using discrete choice experiment. INTRODUCTION Health workforce is directly associated with health service coverage and health outcomes. However, there is a global shortage of healthcare workers (HCWs) in rural areas. Discrete choice experiments can guide the policy and decision-makers to increase recruitment and retention of HCWs in remote and rural areas by determining their job preferences. The aim of this study is to investigate job preferences of senior medical students for mandatory service as general practitioners. METHODS This cross-sectional survey was conducted among 144 medical students. To estimate students' preferences for different levels of job attributes, a mixed logit model was utilised. Simulations of job uptake rates and willingness to pay (WTP) estimates were computed. FINDINGS All attributes had an impact on the job preferences of students with the following order of priority: salary, workload, proximity to family/friends, working environment, facility and developmental status. For a normal workload and a workplace closed to family/friends which were the most valued attributes after salary, WTPs were 2818.8 Turkish lira (TRY) ($398.7) and 2287.5 TRY ($323.6), respectively. The preference weights of various job characteristics were modified by gender, the presence of a HCW parent and willingness to perform mandatory service. To recruit young physicians where they are most needed, monetary incentives appear to be the most efficient intervention. Non-pecuniary job characteristics also affected job preferences. Packages of both monetary and non-monetary incentives tailored to individual characteristics would be the most efficient approach.
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Affiliation(s)
- Buşra Tozduman
- Dokuz Eylul University, Faculty of Medicine, Department of Public Health, Epidemiology Subsection, Izmir, Turkey
| | - Melih Kaan Sözmen
- Izmir Katip Çelebi University, Faculty of Medicine, Department of Public Health, Izmir, Turkey
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA02115, USA
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Li X, Zhang Y, Han Y. The substitution effect of financial and non-financial incentives at different income levels in physician recruitment: evidence from medical students in China. BMC MEDICAL EDUCATION 2024; 24:503. [PMID: 38724945 PMCID: PMC11080174 DOI: 10.1186/s12909-024-05374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/30/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Understanding how medical students respond to financial and non-financial incentives is crucial for recruiting health workers and attracting health talents in medical education. However, both incentives are integrated in working practice, and existing theoretical studies have suggested that various income levels may influence the substitution effect of both incentives, while the empirical evidence is lacking. Furthermore, little attention has been paid to the intrinsic motivation. This study aimed to explore the substitution effect of extrinsic incentives at different income levels, also taking intrinsic altruism into account. METHODS We used the behavioral data from Zhang et al.'s experiments, which involved discrete choice experiments (DCEs) to assess the job preferences of medical students from six teaching hospitals in Beijing, China. The incentive factors included monthly income, work location, work environment, training and career development opportunities, work load, and professional recognition. Additionally, a lab-like experiment in the medical decision-making context was conducted to quantify altruism based on utility function. Furthermore, we separated the choice sets based on the actual income and distinguished the medical students on altruism. The willingness to pay (WTP) was used to estimate the substitution effect of incentives through conditional logit model. RESULTS There was a significant substitution effect between non-financial and financial incentives. As income increased, non-financial incentives such as an excellent work environment, and sufficient career development became relatively more important. The impact of the increase in income on the substitution effect was more pronounced among individuals with higher altruism. Concerning the non-financial incentive work environment, in contrast to the growth of 546 CNY (84 USD) observed in the low-altruism group, the high-altruism group experienced a growth of 1040 CNY (160 USD) in the substitution effect. CONCLUSIONS The increase in the income level exerted an influence on the substitution effect of non-financial incentives and financial incentives, especially in high-altruism medical students. Policymakers should attach importance to a favorable environment and promising career prospects on the basis of ensuring a higher income level. Medical school administrations should focus on promoting altruistic values in medical education, enhancing talent incentives and teaching strategies to encourage medical students to devote themselves to the medical professions.
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Affiliation(s)
- Xinyan Li
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Yue Zhang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
- Qilu Hospital of Shandong University, No.107, Wen Hua Xi Road, Lixia District, Jinan, Shandong, 250012, China
| | - Youli Han
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China.
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Jiang MM, Xiao MF, Zhang JW, Yang MF. Middle-aged and older people's preference for medical-elderly care integrated institutions in China: a discrete choice experiment study. BMC Nurs 2024; 23:32. [PMID: 38200515 PMCID: PMC10777634 DOI: 10.1186/s12912-023-01696-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND With the continuing impact of the aging population, medical-elderly care integrated institutions, as a way to bear the pressure of medical and elderly care, effectively ensure the quality of life of the elderly in their later years. OBJECTIVES To explore the preferences of medical-elderly care integrated institutions among Chinese middle-aged and older people and to provide a reference for establishing elderly-oriented development of medical-elderly care integrated institutions. METHODS In this study, a discrete choice experiment (DCE) was used to investigate the preferences of people aged 45 years and older in medical-elderly care integrated institutions in China from October 20, 2022, to November 10, 2022. A mixed logit regression model was used to analyze the DCE data. Participants' willingness to pay for each attribute was also calculated. RESULTS Data from 420 participants who provided valid responses were included in the analysis. In terms of the choice preference, moderate service quality (vs. poor service quality: β = 1.707, p < 0.001, 95% CI 1.343 ~ 2.071) and high medical technology level (vs. low medical technology level: β = 1.535, p < 0.001, 95% CI 1.240 ~ 1.830) were the most important attributes to middle-aged and older people, followed by monthly cost, environmental facilities, the convenience of transportation, and entertainment activities. Regarding the willingness to pay, participants were more willing to pay for service quality and medical technology level than for other attributes. They were willing to pay $3156 and $2838 more for "poor service quality" and "low medical technology level," respectively, to receive "moderate service quality " (p = 0.007, 95% CI 963 ~ 5349) and "high medical technology level" (p = 0.005, 95% CI 852 ~ 4824). CONCLUSIONS The state should attach great importance to the development of medical-elderly care integrated services industry, actively optimize the model of the medical-elderly care integrated service, improve the facilities, and create a healthy environment. At the same time, give full play to the role of medical insurance, long-term care insurance, and commercial insurance, so as to improve the comprehensive quality of life of the elderly. PUBLIC CONTRIBUTION The design of the experimental selection was guided by 10 experts in the field, 5 Chinese government officials, and interviews and focus group discussions, without whose participation this study would not have been possible.
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Affiliation(s)
- Mao-Min Jiang
- School of Public Affairs, Xiamen University, Xiamen, Fujian province, China
| | - Mei-Fang Xiao
- School of Nursing, Gannan Medical University, Ganzhou, Jiangxi province, China
| | - Jia-Wen Zhang
- Xiamen Institute of Software Technology, Xiamen, China, Fujian province.
- School of Education, Silliman University, Negros Oriental province, Dumaguete, Philippines.
| | - Mei-Fang Yang
- School of Nursing, Southwest Medical University, Luzhou, Sichuan province, China.
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Luo N, Bai R, Sun Y, Li X, Liu L, Xu X, Liu L. Job preferences of master of public health students in China: a discrete choice experiment. BMC MEDICAL EDUCATION 2024; 24:24. [PMID: 38178052 PMCID: PMC10768294 DOI: 10.1186/s12909-023-04993-9] [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: 04/11/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The shortage of public health personnel and the uneven distribution between urban and rural areas are thorny issues in China. Master of public health (MPH) is an integral part of public health human resources in the future, and it is of far-reaching significance to discuss their work preferences. The present study wants to investigate the job preference of MPH, understand the relative importance of different job attributes, and then put forward targeted incentive measures. METHODS Discrete choice experiment (DCE) was used to evaluate the job preference of MPHs in two medical colleges in Liaoning Province. Attributes include employment location, bianzhi, working environment, career development prospects, work value and monthly income. Thirty-six choice sets were developed using a fractional factorial design. Mixed logit models were used to analysis the DCE data. RESULTS The final sample comprised 327 MPHs. All the attributes and levels included in the study are statistically significant. Monthly income is the most important factor for MPHs. For non-economic factors, they value career development prospects most, followed by the employment location. Respondents' preferences are heterogeneous and influenced by individual characteristics. Subgroup analysis showed that respondents from different family backgrounds have different job preferences. Policy simulation suggested that respondents were most sensitive to a salary increase, and the combination of several non-economic factors can also achieve the same effect. CONCLUSIONS Economic factors and non-economic factors significantly affect the job preference of MPHs. To alleviate the shortage and uneven distribution of public health personnel, more effective policy intervention should comprehensively consider the incentive measures of the work itself and pay attention to the individual characteristics and family backgrounds of the target object.
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Affiliation(s)
- Nansheng Luo
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, 110122, Shenyang, Liaoning, China
| | - Ru Bai
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, 110122, Shenyang, Liaoning, China
| | - Yu Sun
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, 110122, Shenyang, Liaoning, China
| | - Xueying Li
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, 110122, Shenyang, Liaoning, China
| | - Libing Liu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, 110122, Shenyang, Liaoning, China
| | - Xin Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, 110004, Shenyang, Liaoning, China.
| | - Li Liu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, 110122, Shenyang, Liaoning, China.
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Haddadfar A, Emamgholipour S, Razani M, Salehnejad MH. Nurses' job preferences for working in deprived areas in Tehran: a discrete choice experiment. HUMAN RESOURCES FOR HEALTH 2023; 21:91. [PMID: 38012632 PMCID: PMC10680310 DOI: 10.1186/s12960-023-00875-9] [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: 07/07/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND In Iran, the issue of the nursing shortage and unequal distribution exist simultaneously. The shortage of healthcare workers is one of the most important concerns of the health systems. In addition, the disparity in the distribution of healthcare workers between large metropolises and remote or non-capital areas has become a serious concern and a top priority to address. We conducted this study to identify and create a sufficient understanding of the different financial and non-financial preferences of nurses for working in deprived areas. METHODS This research was carried out in June and April 2022. It was carried out in three major phases. The factors influencing the nurses' job preferences were first discovered using qualitative methods. The second phase was conducting a pilot study and determining the best design for discrete choice experiment scenarios. The last phase involved publishing the questionnaire to gather information. Data were analyzed (discrete choice analysis) using JMP Pro 16 software. RESULTS A desirable job for the participants (nurses) in this study would have a higher salary, work in a city, the Rasmi employment contract, a low workload, adequate workplace facilities, an appropriate work schedule, and 1 to 3 years spent on the assigned job to promote to a higher position. Willingness to pay (WTP) and the probability of selecting different attribute levels were also calculated and reported. For example, the highest amount of money that a nurse expected to be paid was for changing the geographical location of the workplace from a city to a deprived area. In this case, a nurse tends to receive 91.87 million IRR more to move from a city to a deprived area to work. This amount of money was by far the most among other WTPs. CONCLUSION The results of this study indicated that nurses are willing to forego net income in exchange for other favorable characteristics of their working environment and conditions. This shows that a variety of actions are accessible to policymakers that can greatly enhance the working conditions for nurses. The WTP and the probability of selecting various attributes may help policymakers plan more effectively.
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Affiliation(s)
- Amirmohammad Haddadfar
- Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sara Emamgholipour
- Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Razani
- Department of Psychology, Islamic Azad University, Boroujerd, Iran
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Tian Z, Guo W, Zhai M, Li H. Job preference of preventive medicine students during the COVID-19 pandemic: a discrete choice experiment survey in Shandong Province, China. BMC MEDICAL EDUCATION 2023; 23:890. [PMID: 38012762 PMCID: PMC10680353 DOI: 10.1186/s12909-023-04873-2] [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: 04/20/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Public health workers are a crucial part of the health workforce, particularly during the coronavirus disease (COVID-19) pandemic. They play an important role in achieving universal health coverage and sustainable development goals. Human resources in public health in China are in short supply, their distribution is unequal, and their turnover rate is high. A discrete choice experiment (DCE) was applied to investigate preventive medicine students' preferred job choice criteria and trends in trade-offs by calculating the marginal rate of substitution between these criteria. This study identified the properties of jobs primarily selected by preventive medicine students and estimated the monetary value of each attribute. METHODS Based on discussions and in-depth interviews with preventive medicine students and a literature review, we developed a DCE that assessed how students' stated preferences for a certain choice were influenced by several job attributes, including location, salary, bianzhi, career development opportunities, working environment, and workload. We applied this DCE to preventive medicine students in Shandong Province, China, using a brief, structured questionnaire. Conditional logit models were used to estimate the utility of each job's attributes. Willingness to pay (WTP) was estimated as the ratio of the value of the coefficient of interest to the negative value of the cost attribute. RESULTS A total of 307 respondents completed the questionnaire, and 261 passed the internal consistency test. All the attributes were statistically significant. Career development opportunities and work locations were the most important factors for the respondents. Preference heterogeneity existed among respondents, e.g., 3-year medical education college students placed a higher value on jobs with bianzhi compared to 5-year medical education college students. Furthermore, rural students' WTP for a job located in the county or city is much lower than that of urban students. CONCLUSIONS The heterogeneity of attributes indicates the complexity of job preferences. Monetary and nonmonetary job characteristics significantly influenced the job preferences of preventive medicine students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both job incentives and the backgrounds of preventive medicine graduates.
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Affiliation(s)
- Zhuang Tian
- School of Public Health, Jining Medical University, Jining, 272067, China
| | - Wei Guo
- Public Health Service Center in Rencheng District, Jining, 272412, China
| | - Min Zhai
- School of Public Health, Jining Medical University, Jining, 272067, China
| | - Hongmin Li
- School of Public Health, Jining Medical University, Jining, 272067, China.
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Zhang Y, Lin X, Li X, Han Y. The impacts of altruism levels on the job preferences of medical students: a cross-sectional study in China. BMC MEDICAL EDUCATION 2023; 23:538. [PMID: 37501080 PMCID: PMC10375683 DOI: 10.1186/s12909-023-04490-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 06/30/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Rational allocation of human resources for health is crucial for ensuring public welfare and equitable access to health services. Understanding medical students' job preferences could help develop effective strategies for the recruitment and retention of the health workforce. Most studies explore the relationship between extrinsic incentives and job choices through discrete choice experiments (DCEs). Little attention has been paid to the influence of intrinsic altruism on job choice. This study aimed to explore the heterogeneous preferences of medical students with different levels of altruism regarding extrinsic job attributes. METHODS We conducted an online survey with 925 medical students from six hospitals in Beijing from July to September 2021. The survey combined job-choice scenarios through DCEs and a simulation of a laboratory experiment on medical decision-making behavior. Behavioral data were used to quantify altruism levels by estimating altruistic parameters based on a utility function. We fit mixed logit models to estimate the effects of altruism on job preference. RESULTS All attribute levels had the expected effect on job preferences, among which monthly income (importance weight was 30.46%, 95% CI 29.25%-31.67%) and work location (importance weight was 22.39%, 95% CI 21.14%-23.64%) were the most salient factors. The mean altruistic parameter was 0.84 (s.d. 0.19), indicating that medical students' altruism was generally high. The subgroup analysis showed that individuals with higher altruism levels had a greater preference for non-financial incentives such as an excellent work environment, sufficient training and career development opportunities, and a light workload. The change in the rate of the uptake of a rural position by individuals with lower levels of altruism is sensitive to changes in financial incentives. CONCLUSIONS Medical students' altruism was generally high, and those with higher altruism paid more attention to non-financial incentives. This suggests that policymakers and hospital managers should further focus on nonfinancial incentives to better motivate altruistic physicians, in addition to appropriate economic incentive when designing recruitment and retention interventions. Medical school administrations could attach importance to the promotion of altruistic values in medical education.
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Affiliation(s)
- Yue Zhang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Xing Lin
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Xing Li
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Youli Han
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China.
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Bao M, Huang C, Wang L, Yan G, Chen G. Eliciting primary healthcare physicians' preferences for job characteristics in rural China: a discrete choice experiment. BMJ Open 2023; 13:e056741. [PMID: 36921936 PMCID: PMC10030470 DOI: 10.1136/bmjopen-2021-056741] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
INTRODUCTION The outflow and scarcity of physicians in rural areas can adversely affect universal health coverage and population health outcomes, which are critical concerns in China. This study explored primary healthcare physicians' job preferences using a discrete choice experiment to identify appropriate incentives for retention. METHODS Eight job characteristics were identified through a literature review and qualitative studies as the attributes relevant to designing the discrete choice experiment, with levels varying between two hypothetical jobs. The data were analysed using conditional logit model, mixed logit model and latent class model. RESULTS A total of 1781 licensed physicians (including licensed assistant physicians) from township health centres in rural areas were surveyed. Policy simulation suggested that they were sensitive to both monetary and non-monetary policy incentives. As for non-monetary job characteristics, a highly intense doctor-patient relationship, bianzhi (the number of personnel allocated to each employer by the government) and educational opportunities were highly valued by the respondents. The latent class model could identify distinct groups with different job preferences according to their memberships. CONCLUSION Urban jobs were much preferred to rural ones. However, policy incentives can lend themselves to effective retention strategies. It is also important to tailor policy incentives to different subgroups.
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Affiliation(s)
- Meiling Bao
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- School of Public Health, Guizhou Medical University, Guiyang, Guizhou, China
| | - Cunrui Huang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Lei Wang
- Department of Primary Health, Health Commission of Guizhou Province, Guiyang, Guizhou, China
| | - Gang Yan
- Center of Population Information of Guizhou Province, Guiyang, Guizhou, China
| | - Gang Chen
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Kıyak YS, Budakoğlu Iİ, García-Estañ J, Atta K, Coşkun Ö, Koyun E. What do Turkish, Spanish, and Pakistani medical students value in specialty training positions? A discrete choice experiment. BMC MEDICAL EDUCATION 2022; 22:752. [PMID: 36320062 PMCID: PMC9628137 DOI: 10.1186/s12909-022-03798-6] [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: 06/21/2022] [Revised: 09/08/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The aim of this study was to find out specialty training preferences of senior medical students from three medical schools in Turkey, Spain, and Pakistan. METHODS A Discrete Choice Experiment was carried out using an electronic form for students in three countries in 2021-2022 term. Each choice set in the form consisted of two hypothetical specialty training positions. The attributes were location, earnings, working conditions, personal perspective, quality of education, probability of malpractice, and prestige. Conditional logit model was used to estimate participants' preferences and "willingness to accept" values. RESULTS The most valued attribute was "personal perspective on specialty area" for Turkish and Spanish students, while this attribute was not meaningful for Pakistani students. Turkish students needed a 204% of change in their income for a swap between the specialty that they like and not like. This tradeoff necessitated a 300% change for Spanish students. The most valued attribute for Pakistani students, which was "working conditions", necessitated a 97% increase in income to switch from working in good conditions to working in poor conditions. CONCLUSION In this first multinational DCE study in the medical education literature, we found the preferences of medical students in Turkey, Spain, and Pakistan are affected to various extents by several factors.
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Affiliation(s)
- Yavuz Selim Kıyak
- Department of Medical Education and Informatics, Gazi University Faculty of Medicine, Ankara, Turkey.
| | - Işıl İrem Budakoğlu
- Department of Medical Education and Informatics, Gazi University Faculty of Medicine, Ankara, Turkey
| | | | - Komal Atta
- Department of Medical Education, University Medical and Dental College, The University of Faisalabad, Faisalabad, Pakistan
| | - Özlem Coşkun
- Department of Medical Education and Informatics, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Emin Koyun
- Department of Cardiology, Sivas Cumhuriyet University, Sivas, Turkey
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Sarikhani Y, Ghahramani S, Edirippulige S, Fujisawa Y, Bambling M, Bastani P. What do Iranian physicians value most when choosing a specialty? Evidence from a discrete choice experiment. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2022; 20:23. [PMID: 35619135 PMCID: PMC9134140 DOI: 10.1186/s12962-022-00358-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Choosing a specialty by physicians is fundamentally linked to the performance of health systems and public health outcomes. Identifying the determinants of specialty selection is important to health policy for targeting resources and planning the development of services. This study examined preferences of Iranian physicians for medical specialty using a discrete choice experiment (DCE) method. METHODS In this study, the attributes of the DCE were determined using rigorous qualitative approach. Then we applied D-efficiency criteria to design the DCE and validated it at a pilot study. In the final survey, we recruited participants from six Iranian provinces and analyzed data using conditional logit model. We estimated willingness to pay (WTP) for non-monetary attributes. RESULTS The WTP analysis revealed that the most important non-monetary attributes in the selection of a specialty were job burnout, opportunity for procedural activities, and job prestige. The results imply that the attributes that were related to the quality of personal life was more important only for physicians who preferred to choose non-surgical specialties. CONCLUSIONS The findings demonstrate that traditional gender patterns of specialty selection are changing and quality of personal life characteristics might be the most important factor when developing policies to recruit physicians into non-surgical specialties.
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Affiliation(s)
- Yaser Sarikhani
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran.,Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Almas Building, Alley 29, Qasrodasht Ave, Shiraz, Iran
| | - Sulmaz Ghahramani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Matthew Bambling
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Peivand Bastani
- Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Almas Building, Alley 29, Qasrodasht Ave, Shiraz, Iran. .,Oral Health Centre, School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
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Shi Z, Li S, Chen G. Assessing the Psychometric Properties of the Chinese Version of Ten-Item Personality Inventory (TIPI) Among Medical College Students. Psychol Res Behav Manag 2022; 15:1247-1258. [PMID: 35603350 PMCID: PMC9121988 DOI: 10.2147/prbm.s357913] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022] Open
Abstract
Objective The Ten-Item Personality Inventory (TIPI) was designed as a brief instrument of the Big Five personality traits. This study aimed to explore the internal consistency and structural validity of the Chinese version of TIPI (TIPI-C) in medical college students. Methods A cross-sectional study was conducted in 11 provinces of China. Spearman–Brown coefficient, standardized Cronbach’s α coefficient, and Cronbach’s α coefficient were applied to estimate the internal consistency. Spearman–Brown coefficient was applied to estimate split-half reliability. Principal components analysis (PCA) and confirmatory factor analysis (CFA) were used to identify the structural validity. Results A total of 2223 medical college students recruited from different regions of China were included. The Spearman–Brown coefficients of TIPI-C ranged from 0.129 to 0.786 and the Cronbach’s α coefficients ranged from 0.119 to 0.785. The split-half reliability of the Spearman–Brown coefficient was 0.508. The latent structure of Extraversion, Emotional Stability, and Conscientiousness complied with the intended structure, and the internal consistency coefficients of these three traits were supported. However, the internal consistency coefficients of Agreeableness and Openness were low and the structural validity was not supported. Conclusion TIPI-C primarily stands out as a feasible instrument for brief measurements of the Extraversion, Emotional Stability, and Conscientiousness domains. Further research is required to evaluate the concurrent validity and the test–retest reliability of TIPI-C in different populations and potentially modify the instrument to be more suitable for the Chinese population.
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Affiliation(s)
- Zhao Shi
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, People’s Republic of China
- Center for Health Preference Research, Shandong University, Jinan, Shandong, People’s Republic of China
| | - Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, People’s Republic of China
- Center for Health Preference Research, Shandong University, Jinan, Shandong, People’s Republic of China
- Centre for Quality of Life and Public Policy Research, Shandong University, Jinan, Shandong, People’s Republic of China
- Correspondence: Shunping Li, Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhua Xi Road 44, Jinan, 250012, Shandong, People’s Republic of China, Tel +86-131-8893-4998, Email
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, Australia
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What Are the Important Factors Influencing the Recruitment and Retention of Doctoral Students in a Public Health Setting? A Discrete Choice Experiment Survey in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189474. [PMID: 34574396 PMCID: PMC8467983 DOI: 10.3390/ijerph18189474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/28/2022]
Abstract
Objectives: This study aims to investigate the employment preferences of doctoral students majoring in social medicine and health care management (SMHCM), to inform policymakers and future employers on how to address recruitment and retention requirements at CDCs across China. Methods: An online discrete choice experiment (DCE) was conducted to elicit doctoral SMHCM students’ job preferences. The scenarios were described with seven attributes: monthly income, employment location, housing benefits, children’s education opportunities, working environment, career promotion speed, and bianzhi. A conditional logit model and a mixed logit model were used to evaluate the relative importance of the selected attributes. Results: A total of 167 doctoral SMHCM students from 24 universities completed the online survey. All seven attributes were statistically significant with the expected sign and demonstrated the existence of preference heterogeneity. Monthly income and employment location were of most concern for doctoral SMHCM students when deciding their future jobs. Among the presented attributes, working environment was of least concern. For the sub-group analysis, employment located in a first-tier city was more likely to lead to a higher utility value for doctoral students who were women, married, from an urban area, and had a high annual family income. Unsurprisingly, when compared to single students, married students were willing to forgo more for good educational opportunities for their children. Conclusions: Our study suggests that monthly income and employment location were valued most by doctoral SMHCM students when choosing a job. A more effective human resource policy intervention to attract doctoral SMHCM students to work in CDCs, especially CDCs in third-tier cities should consider both the incentives provided by the job characteristics and the background of students. Doctoral students are at the stages of career preparation, so the results of this study would be informative for policymakers and help them to design the recruitment and retention policies for CDCs.
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Liu P, Liu S, Gong T, Li Q, Chen G, Li S. Job preferences of undergraduate pharmacy students in China: a discrete choice experiment. HUMAN RESOURCES FOR HEALTH 2021; 19:79. [PMID: 34229701 PMCID: PMC8259344 DOI: 10.1186/s12960-021-00626-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/29/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Pharmacists are a crucial part of the health workforce and play an important role in achieving universal health coverage. In China, pharmaceutical human resources are in short supply, and the distribution is unequal. This study aimed to identify the key job characteristics that influence the job preferences of undergraduate pharmacy students and to elicit the relative importance of different job characteristics to shed light on future policy interventions. METHODS A discrete choice experiment was conducted to assess the job preferences of undergraduate pharmacy students from 6 provinces in mainland China. A face-to-face interview was used to collect data. Conditional logit and mixed logit models were used to analyse data, and the final model was chosen according to the model fit statistics. A series of policy simulations was also conducted. RESULTS In total, 581 respondents completed the questionnaire, and 500 respondents who passed the internal consistency test were analysed. All attributes were statistically significant except for open management. Monthly income and work location were most important to respondents, followed by work unit (which refers to the nature of the workplace) and years to promotion. There was preference heterogeneity among respondents, e.g., male students preferred open management, and female students preferred jobs in public institutions. Furthermore, students with an urban background or from a single-child family placed higher value on a job in the city compared to their counterparts. CONCLUSION The heterogeneity of attributes showed the complexity of job preferences. Both monetary and nonmonetary job characteristics significantly influenced the job preferences of pharmacy students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both incentives on the job itself and the background of pharmacy school graduates.
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Affiliation(s)
- Ping Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China
- Centre for Health Preference Research, Shandong University, Jinan, 250012 China
| | - Shimeng Liu
- School of Public Health, Fudan University, Shanghai, 200032 China
- NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, 200032 China
| | - Tiantian Gong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China
- Centre for Health Preference Research, Shandong University, Jinan, 250012 China
| | - Quan Li
- Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, 3145 Australia
| | - Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China
- Centre for Health Preference Research, Shandong University, Jinan, 250012 China
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Putri LP, O’Sullivan BG, Russell DJ, Kippen R. Factors associated with increasing rural doctor supply in Asia-Pacific LMICs: a scoping review. HUMAN RESOURCES FOR HEALTH 2020; 18:93. [PMID: 33261631 PMCID: PMC7706290 DOI: 10.1186/s12960-020-00533-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 11/03/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND More than 60% of the world's rural population live in the Asia-Pacific region. Of these, more than 90% reside in low- and middle-income countries (LMICs). Asia-Pacific LMICs rural populations are more impoverished and have poorer access to medical care, placing them at greater risk of poor health outcomes. Understanding factors associated with doctors working in rural areas is imperative in identifying effective strategies to improve rural medical workforce supply in Asia-Pacific LMICs. METHOD We performed a scoping review of peer-reviewed and grey literature from Asia-Pacific LMICs (1999 to 2019), searching major online databases and web-based resources. The literature was synthesized based on the World Health Organization Global Policy Recommendation categories for increasing access to rural health workers. RESULT Seventy-one articles from 12 LMICs were included. Most were about educational factors (82%), followed by personal and professional support (57%), financial incentives (45%), regulatory (20%), and health systems (13%). Rural background showed strong association with both rural preference and actual work in most studies. There was a paucity in literature on the effect of rural pathway in medical education such as rural-oriented curricula, rural clerkships and internship; however, when combined with other educational and regulatory interventions, they were effective. An additional area, atop of the WHO categories was identified, relating to health system factors, such as governance, health service organization and financing. Studies generally were of low quality-frequently overlooking potential confounding variables, such as respondents' demographic characteristics and career stage-and 39% did not clearly define 'rural'. CONCLUSION This review is consistent with, and extends, most of the existing evidence on effective strategies to recruit and retain rural doctors while specifically informing the range of evidence within the Asia-Pacific LMIC context. Evidence, though confined to 12 countries, is drawn from 20 years' research about a wide range of factors that can be targeted to strengthen strategies to increase rural medical workforce supply in Asia-Pacific LMICs. Multi-faceted approaches were evident, including selecting more students into medical school with a rural background, increasing public-funded universities, in combination with rural-focused education and rural scholarships, workplace and rural living support and ensuring an appropriately financed rural health system. The review identifies the need for more studies in a broader range of Asia-Pacific countries, which expand on all strategy areas, define rural clearly, use multivariate analyses, and test how various strategies relate to doctor's career stages.
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Affiliation(s)
- Likke Prawidya Putri
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, IKM Building 2nd Floor, Jl. Farmako, Sekip Utara, 55281 Yogyakarta, Indonesia
- School of Rural Health, Monash University, 26 Mercy Street, Bendigo, VIC 3550 Australia
| | | | | | - Rebecca Kippen
- School of Rural Health, Monash University, 26 Mercy Street, Bendigo, VIC 3550 Australia
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16
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Dong D, Xu RH, Wong ELY, Hung CT, Feng D, Feng Z, Yeoh EK, Wong SYS. Public preference for COVID-19 vaccines in China: A discrete choice experiment. Health Expect 2020; 23:1543-1578. [PMID: 33022806 PMCID: PMC7752198 DOI: 10.1111/hex.13140] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 01/12/2023] Open
Abstract
Background As the coronavirus disease 2019 (COVID‐19) pandemic is sweeping across the globe, there is an urgent need to develop effective vaccines as the most powerful strategy to end the pandemic. This study aimed to examine how factors related to vaccine characteristics, their social normative influence and convenience of vaccination can affect the public's preference for the uptake of the COVID‐19 vaccine in China. Methods An online discrete choice experiment (DCE) survey was administered to a sample of China's general population. Participants were asked to make a series of hypothetical choices and estimate their preference for different attributes of the vaccine. A mixed logit regression model was used to analyse the DCE data. Willingness to pay for each attribute was also calculated. Results Data of 1236 participants who provided valid responses were included in the analysis. There was strong public preference for high effectiveness of the vaccine, followed by long protective duration, very few adverse events and being manufactured overseas. Price was the least important attribute affecting the public preference in selecting the COVID‐19 vaccine. Conclusions The strong public preferences detected in this study should be considered when developing COVID‐19 vaccination programme in China. The results provide useful information for policymakers to identify the individual and social values for a good vaccination strategy. Patient or Public Contribution The design of the experimental choices was fully based on interviews and focus group discussions participated by 26 Chinese people with diverse socio‐economic backgrounds. Without their participation, the study would not be possible.
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Affiliation(s)
- Dong Dong
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Richard Huan Xu
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi-Tim Hung
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Eng-Kiong Yeoh
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Kazemi Karyani A, Karami Matin B, Malekian P, Moradi Rotvandi D, Amini S, Delavari S, Soltani S, Rezaei S. Preferences of Medical Sciences Students for Work Contracts in Deprived Areas of Iran: A Discrete Choice Experiment Analysis. Risk Manag Healthc Policy 2020; 13:927-939. [PMID: 32801967 PMCID: PMC7406357 DOI: 10.2147/rmhp.s259267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/08/2020] [Indexed: 11/30/2022] Open
Abstract
Background An unequal distribution of human resources affects access to health-care services. This study aimed to elicit the preferences of medical, dentistry, and pharmacy students about attributes of work contracts in deprived areas of Iran; this is a primary important step to decrease inequity. Methods Two-hundred and one students were entered into the study through proportional sample size estimation from Kermanshah University of Medical Sciences in the west of Iran in 2018. The attributes of work contracts were determined using the discrete choice experiment (DCE) method, then possible dual scenarios of work contracts were designed through the D-efficiency method of SAS software and the data were collected using a questionnaire designed by the researchers. The conditional logistic model was used to analyze the data. Results Salary, workplace, side facilities, scholarship, and workload were considered as important factors for working in the deprived areas (p<0.001). There were differences between the students’ preferences regarding their residential areas, majors, and state or tuition-paying education (p<0.001). Higher payments, side facilities, and availability of quota after working in the deprived areas were considered as creators of higher utility, and working in deprived areas and high workload were considered as creators of lower utility (p<0.001). Conclusion This study provides new evidence about the preferences of medical sciences students for work contracts in deprived areas of Iran. According to the findings, money is not the only factor that affects the decisions of medical sciences students related to working contracts in deprived areas of Iran. Designing work contracts that are matched with preferences of the workforce can lead to an improvement in equity, access, and utilization of health-care services.
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Affiliation(s)
- Ali Kazemi Karyani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parisa Malekian
- Students Researches Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Delnia Moradi Rotvandi
- Students Researches Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeed Amini
- Department of Health Services Management, School of Public Health, Arak University of Medical Sciences, Arak, Iran
| | - Sajad Delavari
- Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahin Soltani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Xu RH, Zhou L, Li Y, Wang D. Doctor's Preference in Providing Medical Service for Patients in the Medial Alliance: A pilot Discrete Choice Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2215. [PMID: 32224902 PMCID: PMC7177240 DOI: 10.3390/ijerph17072215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 11/16/2022]
Abstract
This cross-sectional survey study explored whether doctors in Guangdong, China preferred to provide extra healthcare services within the context of their medical alliances (MAs). Specifically, a discrete choice experiment (DCE) was conducted to investigate whether doctors preferred to provide extra services at low-tier hospitals within their MAs. A literature review, focus group interview, and expert group discussion resulted in three main attributes (i.e., working time, income, and hospital location) and corresponding levels, which were combined to create 24 profiles that were randomly presented to participants. A conditional logit model was then employed to calculate utility scores for all profiles. A total of 311 doctors completed the DCE questionnaire. The coefficients for each level within the three attributes were ordered and found to be statistically significant. Working time had the greatest influence on utility scores, increasing by one hour per week (beta = 1.4, odds ratio (OR) = 4.07, p < 0.001), followed by income, which increased by 30% per month (beta = 1.19, OR = 3.3, p < 0.001). The utility scores for all profiles ranged between -0.27 and 3.07. Findings indicated that participants made trade-offs with respect to providing extra services within their MAs. Furthermore, utility varied between different subpopulations.
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Affiliation(s)
- Richard Huan Xu
- Jockey Club School of public health and primary care, the Chinese University of Hong Kong, Hong Kong, China;
| | - Lingming Zhou
- School of Health Management, Southern Medical University, Guangzhou 510515, China; (L.Z.); (Y.L.)
| | - Yong Li
- School of Health Management, Southern Medical University, Guangzhou 510515, China; (L.Z.); (Y.L.)
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou 510515, China; (L.Z.); (Y.L.)
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Liu S, Li S, Li Y, Wang H, Zhao J, Chen G. Job preferences for healthcare administration students in China: A discrete choice experiment. PLoS One 2019; 14:e0211345. [PMID: 30682170 PMCID: PMC6347231 DOI: 10.1371/journal.pone.0211345] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 01/11/2019] [Indexed: 12/16/2022] Open
Abstract
Background There is a deficiency of healthcare administrators in China as compared with other countries; furthermore, the distribution is unequal. To inform an effective policy intervention, it is crucial to understand healthcare administration students’ career decision-making. This study aims to investigate the undergraduate students’ stated preferences when choosing a job. Methods A discrete choice experiment (DCE) was conducted among a population-based multistage sample of 668 final year undergraduate healthcare administration students during April to June 2017 in eight universities of China to elicit their job preferences. Attributes include location, monthly income, bianzhi (which refers to the established posts and can be loosely regarded as state administrative staffing), training and career development opportunity, working environment and workload. Conditional and mixed logit models were used to analyze the relative importance of job attributes. Results All six attributes were statistically significant with the expected sign and demonstrated the existence of preference heterogeneity. Monthly income, workload and working environment were of most concern to healthcare administration students when deciding their future. Among the presented attributes bianzhi was of the least concern. Sub-group analysis showed that students who have an urban background and/or with higher annual family incomes were willing to pay more for working in the city. In addition, students from western and middle universities valued bianzhi higher than students from eastern universities. Conclusions This is the first study focusing on the career decision-making of Chinese healthcare administration students at a critical career decision-making point. Both monetary and non-monetary interventions could be considered by policy-makers to attract students to work in health institutions, especially in rural and remote health institutions in China. There exists preference heterogeneity on healthcare administration students’ job preferences, which should also be taken into account in developing more effective policy incentive packages.
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Affiliation(s)
- Shimeng Liu
- School of Health Care Management, Shandong University, Jinan, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Shunping Li
- School of Health Care Management, Shandong University, Jinan, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Yujia Li
- School of Health Care Management, Shandong University, Jinan, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Haipeng Wang
- School of Health Care Management, Shandong University, Jinan, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Jingjing Zhao
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China.,School of Public Health, Shandong University, Jinan, China
| | - Gang Chen
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
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