Factors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces, China

Ding, Yan; Smith, Helen; Yang, Fei; Xu, Biao; Nie, Shaoping; Yan, Weirong; Diwan, Vinod; Sauerborn, Rainer; Dong, Hengjin

doi:10.2471/blt.12.109447

Cited by 47 publications

(91 citation statements)

References 10 publications

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“…In contrast, local governments purchase public health services from PVCs and VVCs, and subsidize them in accordance with the performance assessment. The subsidies and reimbursements from government are not enough to compensate for the provision of public health services in PVCs and VVCs, and additionally, the doctors in PVCs and VVCs receive less supervision and stewardship from the township hospitals compared to the doctors in HVCs [34,35]. Insufficient government subsidy and limited supervision and stewardship from superior hospitals engenders poorer comprehensive service provision in PVCs and VVCs.…”

Section: Discussionmentioning

confidence: 99%

“…Insufficient government subsidy and limited supervision and stewardship from superior hospitals engenders poorer comprehensive service provision in PVCs and VVCs. This then implies that providing better comprehensive service provision requires government subsidies and township hospital’s supervision for PVCs and VVCs [34–37]. Further studies are needed to identify a reasonable amount of compensation and to develop an effective performance assessment mechanism to motivate the township hospitals to grant timely and fair subsidies, and to encourage PVCs and VVCs to actively provide public health services.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Primary Care Experiences in Village Clinics with Different Ownership Models in Guangdong Province, China

et al. 2017

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ObjectivesIn order to improve the quality of services at village clinics (VCs), which are important primary care service providers in rural China, the Chinese government has encouraged the township hospitals to own and manage VCs. There are currently three models of ownership and management of VCs: township hospital-owned and -managed (HVC), village committee-owned and -managed (VVC), and private-owned and -managed (PVC). This study aims to examine the association between these ownership models of VCs and patients' primary care experiences.MethodsVillagers were selected by multistage stratified sampling and their experiences with primary care were measured using the Primary Care Assessment Tool—Adult Edition (PCAT-AS). Data were collected through face-to-face interviews and the questionnaires administered by investigators in the cross-sectional study from February to April 2015. The PCAT scores were compared among the three models by covariance analysis, and multiple linear regression was used to analyze factors associated with the PCAT total scores.ResultsA total of 1491 questionnaires were collected. After controlling for covariates, HVCs reported the highest PCAT scores and satisfaction rate. In terms of the domains, HVC reported the highest scores in the coordination and comprehensiveness domains, while PVC had the highest scores in the first contact-accessibility domain. Multivariate linear regression showed that HVC, married participants, aged 60 and older, satisfied with the services, receiving six or more visits, and those with medical expenditures over 20% of their total family expenditures, were also positively associated with better primary care quality.ConclusionsThis study demonstrates that villagers receiving medical care at HVCs perceived better primary care than those at PVCs and VVCs. In order to improve the quality of primary care at VCs, it is necessary to increase government subsidies for public service packages, tighten the township hospital's supervision of PVCs and VVCs, and develop performance-based incentive plans to motivate improvements in the accessibility of HVCs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of Primary Care Experiences in Village Clinics with Different Ownership Models in Guangdong Province, China

et al. 2017

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“…However, due to the delayed implementation of the community health service in China, most of the community doctors are not well‐educated; their education, training, and professional development are still in their initial stages. Their service mode and professional title assessment are still based on the clinical specialist model, which differs from the actual needs of the residents . In addition, because China does not implement a strict primary health care system and the professional level of CHCs is the lowest in the urban tertiary health care network, large general hospitals, which are at the top of the network, are overcrowded whereas there are few people in the CHCs …”

Section: Introductionmentioning

confidence: 99%

Factors influencing residents' decision to sign with family doctors under the new health care reform in China

Zhang

Yang

et al. 2019

Health Planning & Management

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Summary Background As an important means through which to promote Chinese health care reform, the family doctor policy has attracted attention from various fields. This study aimed to explore the factors influencing residents' decision to sign with family doctors, with a view to informing the changes necessary to encourage additional residents to do so, thereby enhancing the efficacy of primary health care system reform. Methods The residents of five communities in Xianning, Hubei Province, were selected, by convenience sampling, to participate in the study. We developed and administered a questionnaire to collect data, from which we obtained 725 valid response sets. Socio‐demographic characteristics were summarized using descriptive statistics; and Pearson chi‐squared test and binary logistic regression were performed to identify the factors influencing residents' decision to sign with family doctors. Results We found that the factors influencing residents' decision to sign include their education level, medical insurance, chronic diseases, medical treatment habits, awareness of the family doctor policy, perception of the medical skills of family doctors, and attitudes towards family doctors' signing services (P < .05). Conclusion To encourage more residents to sign with family doctors, we recommend the implementation of the following: increasing publicity for the family doctor policy, promoting the reasonable distribution of high‐quality resources, augmenting the standard of general medical education, and improving the skills and competencies of family doctors.

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“…The Chinese central government passed a landmark program for the health system reform in 2009, which was aimed at improving health care for all citizens by strengthening disease control and the primary care system [8,9]. The new medical reform program calls for the necessity to “build a strong rural health service network at the end; improve rural doctors’ wages; improve rural doctors’ training, increase doctors’ reserve capacity, and gradually promote rural doctors’ ability, help them shift to practicing (assistant) doctors through targeted training”.…”

Section: Introductionmentioning

confidence: 99%

Factors that influence the turnover intention of Chinese village doctors based on the investigation results of Xiangyang City in Hubei Province

Fang

Liu

Huang

et al. 2014

Int J Equity Health

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IntroductionThis study analyzes the factors that influence the turnover intention of village doctors by investigating village clinic workers in rural areas, particularly in Xiangyang City, Hubei Province.MethodsA total of 1184 village clinics were sampled randomly in Xiangyang City. The research assistants distributed 1930 questionnaires to village doctors. This study had a response rate of 97.88%. A total of 1889 village doctors completed the questionnaires.ResultsThe results of the investigation conducted in Xiangyang City indicated that 63.2% of the village doctors did not plan to leave the organization where they were currently employed. However, more than one-third (36.8%) of the village doctors considered leaving their posts voluntarily. Some job satisfaction indexes affect their intention to resign. The results showed that income satisfaction and the way organization policies are put into practice, in addition, my pay and the amount of work I do, the chances for advancement on this job and the work conditions are significant factors that contribute to the turnover intention of village doctors.ConclusionsThis study may interest heath care management administrator and highlight the influence of job satisfaction on turnover intention of village doctors. Our findings outline some issues that contribute to these problems and suggest an approach for health care policy maker to implement a broader national process and organizational strategies to improve the job satisfaction and stability of the village doctors.

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Factors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces, China

Cited by 47 publications

References 10 publications

Comparison of Primary Care Experiences in Village Clinics with Different Ownership Models in Guangdong Province, China

Comparison of Primary Care Experiences in Village Clinics with Different Ownership Models in Guangdong Province, China

Factors influencing residents' decision to sign with family doctors under the new health care reform in China

Factors that influence the turnover intention of Chinese village doctors based on the investigation results of Xiangyang City in Hubei Province

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