Job satisfaction of urban community health workers after the 2009 healthcare reform in China: a systematic review

Zhang, Mingji; Yang, Ruijie; Wang, Wei; Gillespie, James; Clarke, Susan E.; Yan, Fei

doi:10.1093/intqhc/mzv111

Cited by 50 publications

(49 citation statements)

References 26 publications

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“…Growth and development and reputation were identified as the common crucial determinants for both Chinese and Japanese healthcare employees' overall satisfaction. This result is consistent with former studies not only in Japan and China, but also in other countries . Opportunities for professional and status development are very important for healthcare professionals, regardless of country.…”

Section: Discussionsupporting

confidence: 93%

“…Additionally, satisfaction with financial rewards is a crucial predictor to Chinese healthcare staff's overall satisfaction. This finding is similar to studies performed in China and some other developing countries, where the income of healthcare professionals is still at a relatively low level. The patient relationship also contributes significantly to Chinese physicians' overall satisfaction.…”

Section: Discussionsupporting

confidence: 90%

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A comparative study on healthcare employee satisfaction between Japan and China

Itoh

2019

Health Planning & Management

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Summary Objectives To explore essential characteristics of healthcare employee satisfaction by comparing Japan and China in terms of job satisfaction model, satisfaction level, and the crucial factors predicting overall job satisfaction. Methods A questionnaire was developed with 35 facet‐specific job‐related satisfaction and 10 general satisfaction items. The Japanese survey collected 474 responses (74% response rate). Two additional items were added in the Chinese survey and 429 responses were collected (69%). Results The same five‐factor satisfaction model was acquired from both countries with an additional factor labelled “relationship with patients” for China. Applying these factors, a moderate satisfaction level was observed for all professional groups in China, whereas it varied in Japan. A moderate‐to‐high satisfaction was seen for physicians, a moderate level for pharmacists and technologists, and a low level for nurses. Japanese physicians were significantly more satisfied than Chinese physicians, whereas Japanese nurses were less satisfied than Chinese nurses. Both countries shared crucial predictors of overall job satisfaction that were reputation, growth and development, and work demands and workload. Additionally, financial rewards and relationship with patients were critically important for the Chinese. Conclusions Japanese and Chinese healthcare employees shared the job satisfaction model with an extra factor for Chinese. Satisfaction levels were similar for pharmacists and technologists in the two countries, but largely different for physicians and nurses. Because crucial satisfaction factors differed, it is suggested that strategies to improve job satisfaction should be specific to culture and profession, eg, in Chinese hospitals, management should support more to employees especially physicians for dealing with conflicts and medical disputes with patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

A comparative study on healthcare employee satisfaction between Japan and China

Itoh

2019

Health Planning & Management

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“…Defined as ‘one of the biggest health policy interventions in modern history in terms of both scale and scope’ [3], the reform programme has contained a range of measures that aim to achieve universal health coverage through affordable and accessible service provision [4–7]. …”

Section: Introductionmentioning

confidence: 99%

“…Zhang et al [4] call on policy-makers to pay greater attention to improving the financial remuneration for workers in a manner that will be perceived as equitable and motivating. A change to the current fee for service arrangements is also called for with alternative methods such as capitation payments and work-volume-based methods being recommended for allocating government subsidies to prevent profit seeking behaviour [17].…”

Section: Introductionmentioning

confidence: 99%

It’s all about the money? A qualitative study of healthcare worker motivation in urban China

Millar

Chen

Wang

et al. 2017

Int J Equity Health

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BackgroundChina’s healthcare reform programme continues to receive much attention. Central to these discussions has been how the various financial incentives underpinning reform efforts are negatively impacting on the healthcare workforce. Research continues to document these trends, however, qualitative analysis of how these incentives impact on the motivation of healthcare workers remains underdeveloped. Furthermore, the application of motivational theories to make sense of healthcare worker experiences has yet to be undertaken.MethodsThe purpose of our paper is to present a comparative case study account of healthcare worker motivation across urban China. It draws on semi structured interviews (n = 89) with a range of staff and organisations across three provinces. In doing so, the paper analyses how healthcare worker motivation is influenced by a variety of financial incentives; how motivation is influenced by the opportunities for career development; and how motivation is influenced by the day to day pressures of meeting patient expectations.ResultsThe experience of healthcare workers in China highlights how a reliance on financial incentives has challenged their ability to maintain the values and ethos of public service. Our findings suggest greater attention needs to be paid to the motivating factors of improved income and career development. Further work is also needed to nurture and develop the motivation of healthcare workers through the building of trust between fellow workers, patients, and the public.ConclusionsThrough the analysis of healthcare worker motivation, our paper presents a number of ways China can improve its current healthcare reform efforts. It draws on the experience of other countries in calling for policy makers to support alternative approaches to healthcare reform that build on multiple channels of motivation to support healthcare workers.

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“…First, a need for multidisciplinary training was identified, to allow CHWs to innovate and implement broader health solutions in their communities. A desire for additional professional development opportunities has been expressed by community health workers in several areas [15][16][17]. Second, due to limited time, funding, and resources, in-person training for CHWs in international settings poses a challenge; consequently, an IT platform provides one solution to support knowledge sharing and training activities.…”

Section: Community Health Workers As Innovatorsmentioning

confidence: 99%

Community Health Workers as Innovators: Methods and Results from a Tele-Education Pilot for Community Health Workers in Detroit, Michigan

Prentiss

Tamler

Plum³

et al. 2017

Proceedings of the 50th Hawaii International Conference on System Sciences (2017)

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Job satisfaction of urban community health workers after the 2009 healthcare reform in China: a systematic review

Abstract: Financial rewards and professional development were the two main predictors of job satisfaction. To improve CHS in China, policy-makers (especially the central government) need to consider the impact of current policies on job satisfaction in order to reduce job dissatisfaction.

Cited by 50 publications

References 26 publications

A comparative study on healthcare employee satisfaction between Japan and China

A comparative study on healthcare employee satisfaction between Japan and China

It’s all about the money? A qualitative study of healthcare worker motivation in urban China

Community Health Workers as Innovators: Methods and Results from a Tele-Education Pilot for Community Health Workers in Detroit, Michigan

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