Incentive affects physicians’ willingness to participate in urban-rural medical consortia: A comparative study of county and provincial hospitals in Central China

Abstract

Objectives This study had three aims: (a) to examine the incentive measures that effectively affect physicians’ willingness to participate in urban-rural medical consortia. (b) to analyze the differences in the level of incentives implemented by county and provincial hospitals. (c) to identify the differences in incentive effects on county-level and provincial-level physicians’ willingness to participate in projects. Methods An online survey in Henan Province, Central China, was conducted among 1,837 physicians, comprising 1,088 respondents from county hospitals and 749 respondents from provincial hospitals. Participants reported their demographic characteristics, altruism, collaborative projects, incentive levels and willingness to participate. Chi-square and cumulative logistic regressions were used to determine the incentive factors of participants’ willingness. Results (a) For all participants, the level of economic returns and rewards were positively associated with willingness to participate in urban-rural medical consortia, while the level of professional title and status promotion were negatively associated with physicians’ willingness to participate. (b) County-level hospitals had lower level of various incentives for urban-rural medical consortium projects than provincial hospitals. (c) County-level physicians who had a high level of position promotion and professional skills improvement and provincial physicians who had a high level of economic returns and rewards had a high level of willingness to participate in urban-rural medical consortia. Conclusion This result reveals the effectiveness of the financial incentive mechanism and the issue of inadequate implementation of non-financial incentive measures. Comprehensive incentive mechanisms should be established to increase county-level doctors’ perceptions of the benefits of incentives. The rules of financial incentives should be dominated by value-based incentives rather than volume, and non-financial incentives should be standardized implemented for provincial hospitals.