Factors influencing the work passion of Chinese community health service workers: an investigation in five provinces

Abstract

BackgroundAfter the implementation of new healthcare reform, Chinese government paid increasing attention to developing community health service (CHS). The current focus is mainly on cultivating community general practitioners but paying less attention to the working status and occupational demands of in-service CHS workers. Work passion is playing an important role for medical workers. With work passion, CHS workers’ team will become more stable and more effective, ensuring the sustainable development of CHS system. At present, the work passion of CHS workers is relatively low. Studying on influencing factors of work passion of CHS workers, promoting their work passion, and making them keep enthusiasm for work are significant.MethodsA total of 100 CHS organizations were sampled randomly in 10 cities from 5 Chinese provinces for this study. A total of 3450 CHS workers from these CHS institutions took part in the surveys. Questionnaires were used to collect data, including socio-demographic information, work passion and opinion on influencing causes, and work-related satisfaction. Pearson chi-square statistical method was used to identify the factors related to CHS workers’ work passion. Binary logistic regression was performed to determine the significant factors that influence CHS workers’ work passion.ResultsA total of 38.77% of those who accomplished the questionnaire expressed that they didn’t have passion for current work. The related factors that influence CHS workers’ work passion are (1) socio-demographic factors such as age, and years of employment, and (2) other work-related factors such as learning and training opportunities, compensation packages, work stress, and personal development opportunities. CHS workers were most dissatisfied with the balance between remuneration and workload, job promotion opportunities.ConclusionsBased on the results, the government should concern for CHS workers’ working status and work-related demands, pay more attention and meet their demands for reasonable compensation packages and self-development, balance the income and workload, provide more learning and training opportunities and personal development opportunities for CHS workers, in order to promote CHS workers’ work satisfaction, improve their work passion and enthusiasm.

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

“…(d) Improve the development of skills, broaden the scope of training methods, and promote the standardization, specialization, and systematization of general practitioner training, strengthen the development of general medical disciplines and improve the quantity and quality of general practitioners . (e) Establish effective performance appraisal criteria, raise income levels, perfect incentive provision, and stimulate family doctors' work enthusiasm . Conduct quality management and assessment of the services provided by medical staff, and ensure that performance incentives are used to encourage the enthusiasm of family doctors.…”

“…Furthermore, the implementation of the essential drug system has limited the use of drugs in CHCs, making them unable to provide better treatment. All of these have resulted in a serious lack of enthusiasm and innovation in the work of family doctors, 3,26 which is one of the main reasons why "excellent talents cannot be attracted or retained." 16 In order to improve the service capabilities of CHCs, we propose the following suggestions.…”

“…Family doctors are not only primary health care providers but also coordinators of individual patient and community health needs . As the “gatekeeper” of residents' health, family doctors have become an important part of the health care system globally . They play a pivotal role in satisfying public medical needs, optimizing the allocation of health resources, providing health care services, and controlling the increase in medical expenditure .…”

“…There are many studies about the problems of community health service in China. For example, Lou et al indicated that, under normal circumstances, the community health service is not the first choice for residents when they fall ill, and Tang et al found that the passion of doctors in grassroots medical institutions is poor. Additionally, the 2017 Chinese flu epidemic demonstrated the following limitations of community health services: (a) the distribution of high‐quality medical resources is uneven, and the resources of CHCs are poor and the hardware facilities are inadequate; (b) the general practitioner training model is imperfect, the quantity of general practitioners is insufficient, top‐ranking talent is scarce, and medical skills and service quality are deficient; and (c) the enthusiasm of general practitioners cannot be fully engendered due to the lack of effective, scientific performance appraisal criteria, and incentive mechanisms.…”

“…In contrast, the posts of general practitioners in China are mainly held by the original community doctors from CHCs, who only attended short‐term training. Consequently, general practitioners are ill‐equipped and residents are, therefore, distrustful . To improve the service level, the government launched the reform, which requires family doctors to sign service contracts with residents, thereby establishing a long‐term and stable service relationship between family doctors and residents.…”