“Three essential elements” of the primary health care system: A comparison between California in the US and Guangdong in China

Jiang

et al. 2022

Int J Equity Health

Background The serious shortage of human resources for primary health care (PHC) is a common issue in health reforms worldwide. China has proposed that it is an effective way to encourage and guide qualified medical personnel to work in primary health care institutions (PHCIs). However, few studies have been conducted on the willingness and influencing factors of medical personnel to seek employment at PHCIs. Methods Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PHCIs from the perspective of guided objects. Through a three-phase investigation of 1160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors. Results A total of 6 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of PHCIs and SG. The values of the fit index indicated an acceptable-fitting model. Conclusion Family, remuneration, individual development, and job responsibility are closely related to the willingness of medical personnel to seek employment at PHCIs, and the internal and external environment of PHCIs is also an important factor. Therefore, the development of PHC providers can be promoted by paying attention to the family members of medical personnel, establishing a reasonable remuneration system, providing suitable development opportunities, arranging work rationally and improving the internal construction of PHCIs.

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of factors affecting medical personnel seeking employment at primary health care institutions: developing human resources for primary health care

Jiang

et al. 2022

Int J Equity Health

“…The Chinese government has developed various types of training and practice systems for general practitioners to strengthen the human resource development of PMHCIs [ 23 ]. Previous studies have proposed that the government and PMHCIs should focus on addressing medical personnel’s work status and work-related demands [ 24 ]; balancing their work pressures [ 25 ]; improving their financial remuneration [ 26 ]; providing more opportunities for learning, training, and individual development [ 27 ]; increasing their work passion and enthusiasm; reducing their attrition; and improving their technical skill level.…”

Section: Introductionmentioning

confidence: 99%

A New Perspective for Improving the Human Resource Development of Primary Medical and Health Care Institutions: A Structural Equation Model Study

Cao

et al. 2021

IJERPH

In some countries, including China, primary health care is rarely utilized because of medical personnel shortages at primary medical and health care institutions (PMHCIs). Several studies suggest that the most effective solution is to guide qualified doctors and medical graduates to work in PMHCIs, but the studies and measures have been formulated only from the perspective of the government and PMHCIs; few have considered the subjective willingness of medical personnel. Therefore, it is necessary to explore the measures to develop human resources of PMHCIs from the guiding object. This research was divided into two parts based on implicit theory and a lexical approach. The first part collected the factors affecting their choosing PMHCIs for employment, and the second part used exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modeling (SEM) to explore the dimensions and paths of the influencing factors. At last, seven factors were obtained from the EFA, and the SEM hypothesis fit the data well. Internal Organization Development, Patient Factor, Remuneration and Development, and Family Support had a significantly positive effect on the Sense of Gain of medical personnel seeking employment at PMHCIs, whereas both Job Responsibilities and Condition of the City Where the PMHCI Is Located had no significant effect. In addition, the indirect effects of Internal Organization Development and Condition of the City Where the PMHCI Is Located on the Sense of Gain were significant. The Patient Factor, Family Support, and Remuneration and Development significantly mediated the relationship between the internal and external environment of the institution and the Sense of Gain, whereas the mediating effect of Job Responsibilities was not significant. The improvement of family support, remuneration and development, and patient factors increase the willingness of medical personnel to seek employment at PMHCIs. In addition, the internal and external environments of a PMHCI play a vital role in guiding medical personnel to PMHCIs for employment. This research provides theoretical support for improving the development of human resources, guiding medical personnel to work in PMHCIs, and promoting the use of primary care services.

“…The Chinese government has developed various types of training and practice systems for general practitioners to strengthen the human resource development of PMHCIs [24]. Previous studies have proposed that the government and PMHCIs should focus on addressing medical personnel's work status and work-related demands [25], balancing their work pressures [26], improving their nancial remuneration [27], providing more opportunities for learning, training and individual development [28], increasing their work passion and enthusiasm, reducing their attrition, and improving their technical skill level.…”

Section: Introductionmentioning

confidence: 99%

A New Perspective For Improving The Human Resource Development of Primary Medical and Health Care Institutions: A Structural Equation Model Study

Cao

et al. 2021

Preprint

Background: In China, primary health care is rarely utilized because of medical personnel shortages at primary medical and health care institutions (PMHCIs). Several studies suggest that the most effective solution is to guide qualified doctors and medical graduates to work in PMHCIs, but the studies and measures have been formulated only from the perspective of the government and PMHCIs; few have considered the subjective willingness of medical personnel.Methods: From the perspective of the guided objects, this research was divided into two parts based on implicit theory and a lexical method. The first part takes hospital clinical graduates and interns as the survey subjects and collects the factors affecting their choosing PMHCIs for employment. The second part takes candidates for the medical licensing examination as the survey object and uses exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation modeling (SEM) to explore the dimensions and paths of the influencing factors.Results: Seven factors were obtained from the EFA, and the SEM hypothesis fits the data well. Internal Organization Development, Patient Factor, Remuneration and Development, and Family Support had a significantly positive effect on the Sense of Gain of medical personnel seeking employment at PMHCIs, whereas both Job Responsibilities and Condition of the City Where the PMHCI Is Located had no significant effect. In addition, the indirect effects of Internal Organization Development and Condition of the City Where the PMHCI Is Located on the Sense of Gain were significant. The Patient Factor, Family Support, and Remuneration and Development significantly mediated the relationship between the internal and external environment of the institution and the Sense of Gain, whereas the mediating effect of Job Responsibilities was not significant.Conclusions: The improvement of family support, remuneration and development and patient factors increases the willingness of medical personnel to seek employment at PMHCIs. In addition, the internal and external environments of a PMHCI play a vital role in guiding medical personnel to PMHCIs for employment. This research provides theoretical support for improving the development of human resources, guiding medical personnel to work in PMHCIs, and promoting the implementation of medical and health system reform in China.