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Chen W, Xu W, Chen Y, Xu C, Zheng J, Zou Y, Zhou B. Job satisfaction and turnover of the first group of rural-oriented tuition-waived medical students in Guangxi, China: a mixed-method study. BMC PRIMARY CARE 2024; 25:237. [PMID: 38965480 PMCID: PMC11225299 DOI: 10.1186/s12875-024-02486-2] [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: 01/30/2023] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND In 2010, China launched a rural-oriented tuition-waived medical education (RTME) programme to train more general practitioners (GPs) to meet the needs of the rural health workforce. Motivating and maintaining GPs is an important consideration for the shortage in the rural health workforce. This study aimed to investigate job satisfaction and turnover among the first group of rural-oriented tuition-waived medical students (RTMSs) who had completed a three-year compulsory service in Guangxi, as well as the factors affecting RTMSs turnover. METHODS This study adopted a mixed-method approach. A quantitative survey of 129 RTMSs was analysed (81.6% response rate), and qualitative interviews were conducted with 30 stakeholders, including 18 RTMSs, six administrators of the County Health Bureau, and six administrators of township health centers (THCs). A t-test, chi-square test, Fisher's exact test, and logistic regression analysis were used to examine the quantitative data, and thematic analysis was used to analyse the qualitative data. RESULTS Among the 129 participants, the turnover rate was high, with 103 RTMSs reporting turnover (79.84%). Interpersonal relationships scored the highest in job satisfaction (3.63 ± 0.64) among RTMSs, while working conditions were rated the lowest (2.61 ± 0.85). Marital status (odds ratio [OR] = 0.236, 95% confidence interval [95%CI] = 0.059-0.953, P = 0.043), only child status (OR = 8.660, 95%CI = 1.714-43.762, P = 0.009), and job return satisfaction (OR = 0.290, 95%CI = 0.090-0.942, P = 0.039) were significantly associated with turnover. Univariate analyses showed that income had a significant influence on turnover, but the relationship gone by multivariable; however it was deemed important in the qualitative study. Qualitative analysis revealed that turnover was influenced by the working atmosphere, effort-reward imbalance, professional competence, and opportunities for training and promotion. CONCLUSIONS This study provides insights for the policymakers about the priority areas for retaining GPs in rural locations and provides reference values for the retention of GPs in other regions with a shortage of rural health workers. For RTMSs to continue providing services to rural areas, the government should improve their salaries, balance their income and workload, provide more opportunities for training and career promotion, and managers should recognise their efforts and create an optimistic working atmosphere.
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Affiliation(s)
- Wenxu Chen
- School of Information and Management, Guangxi Medical University, Guangxi, 530021, China
| | - Wenjia Xu
- Liuzhou People's Hospital, Liuzhou, Guang xi, 545000, China
| | - Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, 100084, China
| | - Chengying Xu
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Jiahui Zheng
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Yunfeng Zou
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Bo Zhou
- School of Information and Management, Guangxi Medical University, Guangxi, 530021, China.
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Althumairi AA, Bukhari FM, Awary LB, Aljabri D. The effect of transformation policies on healthcare providers' satisfaction in primary healthcare centers: the case of Eastern Saudi Arabia. BMC Health Serv Res 2023; 23:1328. [PMID: 38037068 PMCID: PMC10691092 DOI: 10.1186/s12913-023-10335-8] [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] [Received: 07/20/2023] [Accepted: 11/16/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND The Saudi Arabian Vision 2030 encompasses the Health Sector Transformation Program (HSTP), an initiative aimed at enhancing the accessibility, affordability, and quality of healthcare, with a strong emphasis on patient-centered care. To achieve this vision, the government has been providing training to Primary Healthcare (PHC) centers on patient-centered care, recognizing that spending quality time with patients is crucial for making informed clinical decisions. Therefore, it is essential to evaluate provider satisfaction with the quality of services they provide and assess the impact of organizational factors on care quality. This study represents the first comprehensive assessment of job satisfaction among PHC providers in the Eastern region of Saudi Arabia. It seeks to gauge job satisfaction among PHC providers and explore its associated impact on the quality of care they deliver. METHODS This study employed a quantitative cross-sectional design. Data were collected using a modified version of the Job Satisfaction Survey (JSS), supplemented by three newly added dimensions. Additionally, questions addressing general characteristics were incorporated into the survey instrument. Data analysis involved calculating frequencies and percentages for univariate analysis, employing t-tests for comparisons between two groups, and utilizing ANOVA for comparisons among multiple groups (bivariate analysis). RESULTS A total of 143 PHC providers took part in this study. Of these, 48% reported high satisfaction, while the rest were either dissatisfied or neutral. PHC providers were highly satisfied with supervision (17%, N=94). On the other hand, they were dissatisfied with contingent rewards (3%, N=15). There was a significant difference found between the intention to leave the job (yes, no) and job satisfaction scores (mean (SD)= 83.58 (16.174) vs. mean (SD)=101.64 (16.209), p-value < 0.001). There were also significant relationships between general characteristics and the dimensions such as co-workers, promotion, responsibility, nature of work, operating procedure, and communication (p-value< 0.05). CONCLUSION The main findings of this study suggest that PHC providers working in PHC centers in the Eastern region were satisfied with their work, especially with supervision and patient care. However, the findings also revealed that there are many areas of the job of PHC providers that require planned reform, such as contingent reward and communication. Furthermore, intention to leave the job was significantly related to job satisfaction score and all the dimensions. The study findings will help policymakers and the Ministry of Health to develop an employee engagement and satisfaction program to track the PHC providers' levels of satisfaction.
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Affiliation(s)
- Arwa Abdulrahman Althumairi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman bin Faisal University, P.O. Box 2954, Dammam, 6603-34211, Saudi Arabia.
| | - Fatmah Muhammad Bukhari
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman bin Faisal University, P.O. Box 2954, Dammam, 6603-34211, Saudi Arabia
| | - Layan Bassam Awary
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman bin Faisal University, P.O. Box 2954, Dammam, 6603-34211, Saudi Arabia
| | - Duaa Aljabri
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman bin Faisal University, P.O. Box 2954, Dammam, 6603-34211, Saudi Arabia
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El Mouaddib H, Sebbani M, Mansouri A, Adarmouch L, Amine M. Job satisfaction of primary healthcare professionals (public sector): A cross-sectional study in Morocco. Heliyon 2023; 9:e20357. [PMID: 37809365 PMCID: PMC10560041 DOI: 10.1016/j.heliyon.2023.e20357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 09/13/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
Healthcare professionals (HCPs) are indispensable for improving the availability and quality of healthcare services. Therefore, the present cross-sectional study aimed to measure the job satisfaction of HCPs working in primary care (PC) centers in Marrakech, according to the job satisfaction scale. Using census sampling, this study involved HCPs working in PC centers. Data were collected using an electronic questionnaire and analyzes were performed using Jamovi (version 1.6). The Warr-Cook-Wall scale was used to assess the satisfaction of these professionals. Student's t-test, Kruskal-Wallis test and Mann-Whitney non-parametric tests were used for group comparisons (p < 0.05). The lowest satisfaction scores were recorded for general practitioners (GPs) and nurses. These were work safety (1.54 ± 0.85 vs. 1.51 ± 0.82), salary (1.58 ± 0.79 vs. 1.72 ± 0.87), chance of promotion (1.68 ± 0.87 vs. 1.80 ± 0.93), possibility of using its capacities (1.90 ± 1.04 vs. 2.01 ± 1.08), and workload (1.88 ± 1.10 vs. 2.05 ± 1.06). A statistically significant difference was observed between different professional statuses regarding facility management (p = 0.049). The overall job satisfaction of HCPs was low, especially among GPs and nurses: the scores for intrinsic job satisfaction with respect to sociodemographic characteristics were low, whereas they were medium for extrinsic job satisfaction. Further research is warranted to clarify the intrinsic and extrinsic factors of job satisfaction in Morocco's healthcare sector.
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Affiliation(s)
- Hicham El Mouaddib
- Bioscience & Health Laboratory, BHL, Cadi Ayyad University, 40000, Marrakesh, Morocco
| | - Majda Sebbani
- Bioscience & Health Laboratory, BHL, Cadi Ayyad University, 40000, Marrakesh, Morocco
- Clinical Research Unit, Mohammed VI University Hospital, 40000, Marrakesh, Morocco
- Community Medicine and Public Health Department, School of Medicine, Cadi Ayyad University, Sidi Abbad, 40000, Marrakesh, Morocco
- Unit of Development and Research in Medical Education, Geneva University, Switzerland
| | - Adil Mansouri
- Clinical Research Unit, Mohammed VI University Hospital, 40000, Marrakesh, Morocco
- Community Medicine and Public Health Department, School of Medicine, Cadi Ayyad University, Sidi Abbad, 40000, Marrakesh, Morocco
| | - Latifa Adarmouch
- Bioscience & Health Laboratory, BHL, Cadi Ayyad University, 40000, Marrakesh, Morocco
- Clinical Research Unit, Mohammed VI University Hospital, 40000, Marrakesh, Morocco
- Community Medicine and Public Health Department, School of Medicine, Cadi Ayyad University, Sidi Abbad, 40000, Marrakesh, Morocco
| | - Mohamed Amine
- Bioscience & Health Laboratory, BHL, Cadi Ayyad University, 40000, Marrakesh, Morocco
- Clinical Research Unit, Mohammed VI University Hospital, 40000, Marrakesh, Morocco
- Community Medicine and Public Health Department, School of Medicine, Cadi Ayyad University, Sidi Abbad, 40000, Marrakesh, Morocco
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Ning L, Jia H, Gao S, Liu M, Xu J, Ge S, Li M, Yu X. The mediating role of job satisfaction and presenteeism on the relationship between job stress and turnover intention among primary health care workers. Int J Equity Health 2023; 22:155. [PMID: 37582742 PMCID: PMC10428580 DOI: 10.1186/s12939-023-01971-x] [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] [Received: 04/25/2023] [Accepted: 07/21/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Turnover problems among primary health care workers are a significant contributor to the shortage of health human resources. This study aims to determine the relationship between job stress and turnover intention among primary health care workers, as well as to examine the mediating effects of job satisfaction and presenteeism on this relationship. METHODS Stratified random sampling and quota sampling were used to select 703 primary health care workers in Jilin Province, China in January 2020. Validated scales were used to measure turnover intention, job stress, job satisfaction, and presenteeism among primary health care workers. The study utilized a partial least squares structural equation modeling (PLS-SEM) approach to test the research hypotheses. RESULTS The turnover intention score of primary health care workers in Jilin Province was 2.15 ± 1.03, and 19.5% of respondents reported a higher turnover intention. Significant sex and occupation differences were found, with a higher rate of turnover intention for male and doctor groups among primary health care workers. This study also revealed a positive correlation between job stress and turnover intention (β = 0.235, P < 0.001), a significant negative correlation between job satisfaction and turnover intention (β= -0.347, P < 0.001), and a significant positive correlation between presenteeism and turnover intention (β = 0.153, P < 0.001). Moreover, the study revealed a significant indirect effect of job stress on turnover intention which was mediated by job satisfaction (β = 0.183, P < 0.001) and presenteeism (β = 0.078, P < 0.001). CONCLUSION We confirmed the positive association between job stress and presenteeism with turnover intention, as well as the negative association between job satisfaction and turnover intention. Moreover, our study confirmed the mediating role of job satisfaction and presenteeism in the relationship between job stress and turnover intention. This study provides scientific evidence to address the turnover problem among primary health care workers.
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Affiliation(s)
- Liangwen Ning
- School of Public Administration, Jilin University, Changchun City, Jilin Province, China
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Huanhuan Jia
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Shang Gao
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Minghui Liu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Jiaying Xu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Sangyangji Ge
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Ming Li
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Xihe Yu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China.
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Jin R, Chen Y. Job satisfaction of village doctors in a rural-oriented tuition-waived medical education program in China. Front Psychol 2023; 14:1184430. [PMID: 37560095 PMCID: PMC10408449 DOI: 10.3389/fpsyg.2023.1184430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/22/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION To address health inequity and relieve shortage of rural doctors, China initiated Rural-oriented Tuition-waived Medical Education (RTME) to train doctors in rural areas for free since 2010. Little is known about job satisfaction of this particular group of rural doctors. METHODS Job Satisfaction Questionnaires for Village Doctors were distributed to 240 village doctors with RTME program in China, and 40 received in-depth semi-structured interviews. Descriptive analysis, chi-square test, univariate and multivariate logistic regressions in SPSS23.0 were conducted, and thematic analysis was applied to interviews. RESULTS Job satisfaction rate of village doctors with RTME program was 56.50%. Full understanding of RTME policy, recognition of rural medical work, relevance of RTME curriculum with present job, education background, rural origin and renumeration were positively correlated with job satisfaction. Preferential policies of RTME program, relaxing working atmosphere, more promotion opportunity, and easier access to higher technical titles were the key factors to retain rural doctors. CONCLUSION Our findings may interest healthcare authorities, medical colleges and primary healthcare establishments. Studying the job satisfaction of village doctors in China may also be beneficial in developing community and rural health services, and provide valuable insights into the training and retention of primary healthcare providers in other countries.
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Affiliation(s)
- Renmin Jin
- Party School of Anhui Provincial Committee of C.P.C, Hefei, China
| | - Yan Chen
- Anhui Medical College, Hefei, China
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Karaferis D, Aletras V, Niakas D. Job satisfaction of primary healthcare professionals: a cross-sectional survey in Greece. ACTA BIO-MEDICA : ATENEI PARMENSIS 2023; 94:e2023077. [PMID: 37326279 PMCID: PMC10308459 DOI: 10.23750/abm.v94i3.13878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The role of job satisfaction is essential for the operation of public Primary Healthcare Centers in Greece. The dimensions of job satisfaction can be used to gauge employees' engagement and performance. METHODS Job Satisfaction Survey was employed among healthcare professionals in 32 Primary Healthcare Centers, between June 2019 and October 2020. The 36 items of the questionnaire are expressed on a six-point Likert scale divided into 9 aspects: salary, promotion, supervision, fringe benefits, contingent rewards, operating procedures, co-workers, nature of work, and communication. Additional questions were added covering sociodemographic characteristics. RESULTS A total of 1,007 professionals completed the questionnaire (83.92% response rate), of which 51.04% were nurses, 27.61% physicians, and 21.35% other healthcare employees. The average overall job satisfaction score indicates ambivalence (3.63 out of 6). Participants were dissatisfied with salaries (2.38) and promotion (2.84) aspects and ambivalent regarding fringe benefits (3.04), operating procedures (3.23), and contingent rewards (3.30). Moderate satisfaction was reported for the nature of work (4.53), supervision (4.52), co-workers (4.37), and communication (4.22). Nurses by far reported the lower levels of satisfaction in all dimension except communication compared to the other groups. CONCLUSIONS The findings suggest that decreasing administrative workload and the improvement of working conditions, procedures, payment, and provision of better opportunities for the promotion of PHC professionals might be the most effective ways to subsequently improve their subjective well-being and their job satisfaction which in turn will improve their performance.
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Affiliation(s)
- Dimitris Karaferis
- Msc, PhD(c), Department of Health Economics, Medical School, National and Kapodistrian University of Athens.
| | - Vassilis Aletras
- Department of Business Administration, University of Macedonia, Thessaloniki, Greece.
| | - Dimitris Niakas
- Department of Health Economics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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Bonsaksen T, Horghagen S, Arntzen C, Gramstad A, Stigen L. Job Satisfaction among Occupational Therapists Employed in Primary Care Services in Norway. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5062. [PMID: 36981971 PMCID: PMC10049391 DOI: 10.3390/ijerph20065062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 06/18/2023]
Abstract
The aging population will place healthcare services under considerable strain in the years ahead. Occupational therapists play a vital role in securing sustainable healthcare services and are increasingly employed by municipalities. To promote sustainable services, the job satisfaction among core professional groups needs monitoring. A comprehensive cross-sectional survey was distributed among municipality-employed occupational therapists in Norway during May-June 2022, to which 617 responded. Job satisfaction was assessed with the Job Satisfaction Scale (JSS), and factors associated with job satisfaction were assessed with linear regression analysis. The mean JSS score in the sample was 51.4. The regression model explained 14.4% of the variance in job satisfaction scores. Having more work experience as an occupational therapist (β = 0.16, p = 0.02) and having higher perceived influence on the work unit's goals (β = 0.31, p < 0.001) were significantly related to higher job satisfaction. The study implies that job satisfaction in the occupational therapy profession increases with years of experience and also with the ability to engage with and influence the larger work environment. Thus, to promote job satisfaction, occupational therapists should seek to engage not only with their own work at hand but also with the larger goals and strategies of the organization they work for.
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Affiliation(s)
- Tore Bonsaksen
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, 2418 Elverum, Norway
- Department of Health, VID Specialized University, 4024 Stavanger, Norway
| | - Sissel Horghagen
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - Cathrine Arntzen
- Department of Health and Care Sciences, UiT the Arctic University of Norway, 9037 Tromsø, Norway
- Centre for Care Research, North, 9037 Tromsø, Norway
| | - Astrid Gramstad
- Department of Health and Care Sciences, UiT the Arctic University of Norway, 9037 Tromsø, Norway
- Centre for Care Research, North, 9037 Tromsø, Norway
| | - Linda Stigen
- Department of Health Sciences Gjøvik, Norwegian University of Science and Technology, 2802 Gjøvik, Norway
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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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Chen Y, You Y, Wang Y, Wang Y, Dai T. Global Insights Into Rural Health Workers' Job Satisfaction: A Scientometric Perspective. Front Public Health 2022; 10:895659. [PMID: 35784240 PMCID: PMC9249262 DOI: 10.3389/fpubh.2022.895659] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/10/2022] [Indexed: 12/28/2022] Open
Abstract
Introduction Rural health workers (RHWs) play an irreplaceable role in ensuring and improving the health level of rural residents as the most basic and extensive medical service providers in rural areas. However, rural health institutions are facing significant worker shortages worldwide, not only in low- and middle-income countries but also in developed countries. As an important variable to explain RHWs' work status and predict turnover behavior, job satisfaction has received more and more attention currently. Methods Publications from 1 January 1995 to 31 December 2021 were identified from the Science Citation Index Expanded (SCI-Expanded), the Social Sciences Citation Index (SSCI), and the Emerging Sources Citation Index (ESCI) of the Web of Science Core Collection (WoSCC); CiteSpace, VOSviewer, and R software were applied to conduct this study. Results A total of 251 publications were obtained from the WoSCC database. The number of publications had a statistically significant increase in the study period. Ranking in the top three of the most productive countries or regions in this field was the United States, the United Kingdom, and China. "Health Care Sciences & Services," "Nursing," and "Public, Environmental & Occupational Health" seemed to be the major subjects. According to the reference co-citation analysis, "motivation," "rural and remote areas," and "work environment" were three noteworthy topics during the development of the research field. Moreover, through the keyword analysis, the underlying relationship among "job satisfaction," "job burnout," and "turnover intention" was explored. Conclusion Publications about job satisfaction associated with RHWs had remarkably indicated that this research field had great development potential and broad prospects. As an emerging topic related to RHWs' job status, job satisfaction and its related affected factors were systematically summarized by cluster and keywords analysis. We also highlighted that job satisfaction had a negative predictive effect on RHWs' job burnout and turnover intention, and job burnout played a positive role in predicting turnover intention. In addition, the job satisfaction and working environment of RHWs under the COVID-19 pandemic should receive more attention in the future.
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Affiliation(s)
- Yuquan Chen
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yanwei You
- School of Social Sciences, Tsinghua University, Beijing, China
| | - Yiche Wang
- Department of Economics and Management, Shanghai University of Sport, Shanghai, China
| | - Yutong Wang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tao Dai
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
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Sang L, Liu H, Yan H, Rong J, Cheng J, Wang L, Li G, Guo Y, Zhang L, Ding H, Chen G, Chen R. Incentive Preferences and Its Related Factors Among Primary Medical Staff in Anhui Province, China: A Cross-Sectional Study. Front Public Health 2022; 9:778104. [PMID: 35071164 PMCID: PMC8769285 DOI: 10.3389/fpubh.2021.778104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/22/2021] [Indexed: 11/27/2022] Open
Abstract
Background: The shortage of primary medical staff is a major problem in the management of health human resources across many developing countries. By determining their preferences for various motivational and related factors, we examined the correlation between staff's motivation preference levels and staff turnover and turnover intention. This study aimed to further improve the incentive mechanism and to provide a reference for healthcare managers to formulate management strategies for the primary medical staff team. Methods: A self-reported questionnaire survey was conducted to collect data. The basic survey content included demographic characteristics. The absolute level questionnaire and relative level questionnaire on the factors affecting motivation preference were used as the main assessment scales. A total of 1,112 primary health workers in Anhui Province were investigated. T-test, analysis of variance (ANOVA), exploratory factor analysis, and multiple linear regression analysis were performed to analyze the data. Results: The survey respondents (45.1%) reported being satisfied with their relationship with colleagues, and other social relationships (46.9%). The Kaiser Meyer Olkin (KMO) value for the absolute preference degree for motivational factors was 0.951. Two factors (economic and non-economic factors), after using the maximum variance rotation axis method, explained 81.25% of the total variance. The regression analysis showed that primary medical staff members with low monthly income (B = −0.157) have a higher preference for non-economic factors; the higher the educational background (B = 0.133), the higher their preference for economic factors. In addition, with the increase in participants' age (B = −0.250), the preference for motivational factors gradually decreased. Conclusion: Both economic and non-economic factors play an important role in enhancing the enthusiasm of primary medical workers and improving their work attitude. Managers should use their influence to stabilize the primary medical staff.
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Affiliation(s)
- Lingzhi Sang
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Hongzhang Liu
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Huosheng Yan
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Jian Rong
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Jing Cheng
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Li Wang
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Guoqiang Li
- Affiliated Suzhou Hospital of Anhui Medical University, Suzhou, China
| | - Yan Guo
- Affiliated Suzhou Hospital of Anhui Medical University, Suzhou, China
| | - Lei Zhang
- Affiliated Suzhou Hospital of Anhui Medical University, Suzhou, China
| | - Hong Ding
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Guimei Chen
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Ren Chen
- School of Health Services Management, Anhui Medical University, Hefei, China.,Affiliated Suzhou Hospital of Anhui Medical University, Suzhou, China
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11
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Yan W, Gao X, Wang W, Zhou Z, Zou C, Lu Z. Job satisfaction of graduates of rural oriented medical students training project in Jiangsu Province, China: a cross-sectional study. BMC MEDICAL EDUCATION 2022; 22:9. [PMID: 34980072 PMCID: PMC8722068 DOI: 10.1186/s12909-021-03074-z] [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: 05/04/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The Chinese government has worked out the "Rural Oriented Medical Students Training Project" to address physician maldistribution, which attempted to train physicians for rural areas. The present study attempted to evaluate the job satisfaction of the graduates of this project in Jiangsu Province, China. METHODS Online questionnaires were sent to the graduates of the "Rural Oriented Medical Students Training Project" (group A) and their colleagues, who were rural physicians recruited from different sources (group B). The study was approved by the Ethics Committee of Xuzhou Medical University, and the approval number was 2,018,057. Information on demographic characteristics, work conditions, and self-reported satisfaction was collected to compare the satisfaction differences between the two recruited rural physicians using the Chi-square test and Mann-Whitney U test. Additionally, factors correlated to the satisfaction of group A were assessed using multivariate linear regression. Statistical analysis was performed using SPSS 23.0 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered statistically significant. RESULTS Group A exhibited moderate satisfaction (2.81 ± 0.687). The satisfaction score from the highest to the lowest was for occupational ecology, life satisfaction, stress, competency, and internal environment. Positive factors related to the satisfaction of group A were area, monthly income, working hours per week, professional title, and post. CONCLUSION The satisfaction of the graduates of the "Rural Oriented Medical Students Training Project" was moderate. Factors related to satisfaction included economic incentives, workload, and professional confidence. Possible solutions for increasing satisfaction should consist of economic support and possible ways to improve the professional identification of these graduates.
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Affiliation(s)
- Wenjun Yan
- Department of General Practice, School of Public Health, Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China.
| | - Xiuyin Gao
- Department of General Practice, School of Public Health, Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Wei Wang
- Department of General Practice, School of Public Health, Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Zhengyu Zhou
- West-City Central Hospital, Lianyungang, 222100, Jiangsu, China
| | - Chao Zou
- Ma-an Community Health Centre, Nanjing, 211500, Jiangsu, China
| | - Zhaojun Lu
- Second Clinical Medical College, Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
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12
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Family characteristics associated with rural households' willingness to renew the family doctor contract services: a cross-sectional study in Shandong, China. BMC Public Health 2021; 21:1282. [PMID: 34193114 PMCID: PMC8246675 DOI: 10.1186/s12889-021-11048-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background In China, some previous studies have investigated the signing rate and willingness of residents to sign the family doctor contract services (FDCS). Few studies have explored residents’ willingness to renew the FDCS. This study is designed to understand the family characteristics difference towards rural households’ willingness of maintaining the FDCS. Methods A total of 823 rural households were included in the analysis. A descriptive analysis was conducted to describe the sample characteristics. The binary logistic regression model was used to explore the family characteristics that influence the renewal willingness for FDCS among rural households in Shandong province, China. Results Our study found that about 95.5% rural households had willingness to maintain the FDCS in Shandong, China. Those households with catastrophic health expenditures (CHE) (OR = 0.328, 95%CI = 0.153–0.703), with highest level of education at graduate or above (OR = 0.303, 95%CI = 0.123–0.747) were less willing to maintain the FDCS. Those whose households have more than half of the labor force (OR = 0.403, 95%CI = 0.173–0.941) and those households living in economically higher condition were less willing to maintain the FDCS. Conclusions This study demonstrates a significant association between family characteristics (CHE, highest education in households, proportion of the household labor force) and willingness to maintain FDCS among rural households in Shandong, China. Targeted policies should be made for rural residents of identified at-risk families. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11048-5.
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13
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Saif-Ur-Rahman KM, Onishi J, Mamun R, Suenaga H, Chiang C, Hirakawa Y. Job satisfaction among physicians providing health care to the elderly in Japan: a qualitative study. Psychogeriatrics 2021; 21:311-316. [PMID: 33598980 DOI: 10.1111/psyg.12668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/22/2020] [Accepted: 02/01/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Physicians' job satisfaction plays an important role in service delivery. Japan is a country with a higher number of elderly people and their medical care is a crucial issue. To date, no study has been conducted on the job satisfaction of geriatricians serving the elderly in Japan. This study aims to explore the job satisfaction and motivation of physicians providing health care to the elderly working at different hospitals in Japan. METHODS In-depth interview of 23 geriatric physicians was conducted and data were coded and analysed. Qualitative content analysis was conducted to identify the response themes. RESULTS Three major themes emerged from the analysis and they are: satisfaction as a primary care provider, career development, and suitable communication with patients. Geriatric physicians enjoy their work with inter-professional collaboration and are satisfied to provide primary health care to elderly people. Geriatrics is a very promising career to them and they enjoy the communication and empathetic doctor-patient relationship in their service. CONCLUSIONS Japanese physicians providing health care to the elderly are enjoying their work due to a suitable environment, multi-professional collaboration, work-life balance, and patient-doctor relationship.
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Affiliation(s)
- K M Saif-Ur-Rahman
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Joji Onishi
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Razib Mamun
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Haruki Suenaga
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Chifa Chiang
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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14
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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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15
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Zhang X, Bian L, Bai X, Kong D, Liu L, Chen Q, Li N. The influence of job satisfaction, resilience and work engagement on turnover intention among village doctors in China: a cross-sectional study. BMC Health Serv Res 2020; 20:283. [PMID: 32252746 PMCID: PMC7133112 DOI: 10.1186/s12913-020-05154-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 03/25/2020] [Indexed: 12/29/2022] Open
Abstract
Background As the gatekeepers of rural residents’ health, teams of village doctors play a vital role in improving rural residents’ health. However, the high turnover of village doctors, both individually and collectively, threaten the stability of village medical teams. This research evaluated the influence of job satisfaction, resilience, and work engagement on the village doctors’ turnover intention, and explored the mediating role of work engagement and resilience between job satisfaction and the turnover intention of village doctors in China. Methods A quantitative study using a self-administered questionnaire containing mostly structured items was conducted among village doctors with a sample size of 2693 from 1345 rural clinics in Shandong province, China, during May and June 2019. All variables including demographic characteristics, job satisfaction, resilience, work engagement and turnover intention were based on available literature, and measured on a 5- or 6-point Likert scale. Such statistical methods as one-way ANOVA, bivariate correlation, exploratory factor analysis (EFA), and Structural Equation Modelling (SEM) were used. Results Up to 46.9% of the subjects had a higher turnover intention and more than 26.3% of them had a medium turnover intention. The job satisfaction of village doctors could not only have a direct negative effect on turnover intention (β = − 0.37, p < 0.001), but also have an indirect effect through work engagement (β = − 0.04,=< 0.001). Meanwhile, work engagement also had a direct negative impact on turnover intention (β = − 0.13, p < 0.001), and resilience had an indirect negative impact on turnover intention through work engagement (β = − 0.09, p < 0.001). The above results of this study strongly confirmed that job satisfaction, resilience, and work engagement were early, powerful predicators of village doctors’ turnover intention. Conclusion According to the results, the following should be taken seriously to improve job satisfaction: reasonable and fair income, effective promotion mechanism, fair social old-age security, reasonable workload, and strong psychological coping mechanisms for work stress. The turnover intention of village doctors could be reduced through improving job satisfaction, resilience and work engagement.
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Affiliation(s)
- Xuewen Zhang
- Department of Health and Social Behaviour, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.,School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067, China
| | - Liyan Bian
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067, China
| | - Xue Bai
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067, China
| | - Dezhong Kong
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067, China
| | - Li Liu
- Department of Health and Social Behaviour, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Qing Chen
- Department of Health and Social Behaviour, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Ningxiu Li
- Department of Health and Social Behaviour, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
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16
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Morikawa MJ. Family medicine training in China: crisis and opportunity. Fam Med Community Health 2020; 8:e000283. [PMID: 32148737 PMCID: PMC7032899 DOI: 10.1136/fmch-2019-000283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/10/2020] [Accepted: 01/15/2020] [Indexed: 11/03/2022] Open
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17
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Ibrahim H, Allebdi A. Level and determinants of job satisfaction among Saudi physicians working in primary health-care facilities in Western Region, KSA. J Family Med Prim Care 2020; 9:4656-4661. [PMID: 33209779 PMCID: PMC7652182 DOI: 10.4103/jfmpc.jfmpc_428_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/25/2020] [Accepted: 07/11/2020] [Indexed: 11/08/2022] Open
Abstract
Introduction: Job satisfaction is an important factor influencing the health of workers and is directly related to quality of care. Objectives: To assess the level of job satisfaction and factors contributing to dissatisfaction of Saudi physicians in primary health care centers in Jeddah. Methods All Saudi physicians working in primary health care centers in a city in the Western region, KSA, were included in this web-based survey using the “Job Satisfaction Survey” questionnaire adopted by Paul E. Spector (1994). In addition, socio-demographic data (age, sex, marital status, work facilities, qualification, work experience and income) were collected (response rate 83% ). Results: 63% of the physicians are satisfied about the nature of work in the primary health care centers, while 25.2% were satisfied about the payment. A large proportion of respondents were dissatisfied about the contingent rewards and fringe benefits (83.2%, 76.5%respectively). None of the specialists were satisfied about the work compared to 10.6% of the general practitioners. Conclusion: Slightly less than half of the physicians are satisfied. Financial incentives (contingent rewards and fringe benefits) impose a negative impact on job satisfaction for primary care physicians. On the other side, the nature of work has had the most positive impact on job satisfaction. Specialists were found to have less satisfaction. Investing in the physicians’ satisfaction about the nature of work in the primary healthcare facilities to create a sense of ownership that would be reflected on the quality of patient care is required. There is a need to conduct further studies on the fiscal privileges that lead to job satisfaction among physicians.
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Wang H, Shi L, Han X, Zhang J, Ma Y, Yang X, Liu M, Fan L, Lou F. Factors associated with contracted services of Chinese family doctors from the perspective of medical staff and consumers: a cross-sectional study. BMC Health Serv Res 2019; 19:986. [PMID: 31864354 PMCID: PMC6925852 DOI: 10.1186/s12913-019-4801-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 12/02/2019] [Indexed: 12/21/2022] Open
Abstract
Background The family doctor system has developed rapidly all over the world, and in the past few years, China has actively explored family doctor-type contracted services. This study aimed to explore the related factors of Contracted Family Doctors Services (CFDS) from the perspectives of medical staff and consumers, and to provide a stronger basis for the development and promotion of CFDS. Methods A combination of quantitative and qualitative methods were used in this study. A self-reported questionnaire was designed through a literature analysis, group discussions, expert consultations and a pre-investigation, and conducted among community health service providers in 12 community health service centres across four provinces of China. A total of 389 participants participated, and 320 valid questionnaires were obtained, with an effective response rate of 82.3%. A total of 36 consumers participated in in-depth interviews, and the effective rate was 100.0%. An exploratory factor analysis, a confirmatory factor analysis, inductive methods, and expert consultations were used to analyse the related factors of CFDS. Results The related factors of CFDS from the perspectives of medical staff were divided into four dimensions, with the following weighting coefficients: national government factors (31.9%), community health service agency factors (24.7%), consumer-related factors (22.6%), and contracted doctor-related factors (20.8%). The related factors of CFDS from the perspectives of consumers were divided into four dimensions, with the following frequency sequence: national government factors, contract doctor-related factors, community health service agency factors, and consumers-related factors. National government factors played an important role in CFDS from the perspectives of medical staff and consumers. Conclusions The related factors of CFDS were the same from the perspective of medical staff and consumers, but the weight of each factor was different. The development of CFDS is inseparable from the support of policies. It is suggested that the government should strengthen the publicity of CFDS, expand the coverage, introduce personalised contract programs that meet the needs of different groups, and promote the rapid development of CFDS.
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Affiliation(s)
- Huanyan Wang
- Department of Health Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China.,Human Resource Office, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Lei Shi
- Department of Health Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China
| | - Xuanye Han
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jinchan Zhang
- Department of Medical Dispute, Maternal and Child Health Hospital, Heyuan, Guangdong, China
| | - Yuanshuo Ma
- Department of Health Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China
| | - Xi Yang
- Department of Health Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China
| | - Ming Liu
- Department of Health Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China
| | - Lihua Fan
- Department of Health Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China.
| | - Fengge Lou
- Department of Public Health Research, School of Public Health, Qiqihar Medical University, Qiqihar, Heilongjiang, China.
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