BackgroundShortage and mal-distribution of nursing human resources is an intractable problem in China. There is an urgent need to explore the job preferences of undergraduate nursing students. The main aim of this study is to investigate the stated preferences of nursing students when choosing a job.MethodsA discrete choice experiment (DCE) was conducted to assess job preferences of the final year undergraduate nursing students from four medical universities/colleges in Shandong Province, China. Job attributes include location, monthly income, bianzhi (which refers to the established posts and can be loosely regarded as state administrative staffing), career development and training opportunity, work environment and working strength. Mixed logit models were used to analyze the DCE data.ResultsA total of 445 undergraduate nursing students were included in the main DCE analysis. They demonstrated higher preference for a job with higher monthly income, and the probability of choosing a rural job would increase to 92.8% if monthly income increased from RMB 2000 (US$ 296) to RMB 8000 (US$ 1183). They expressed higher stated preferences for a job which required light working strength and with excellent work environment over other non-economic attributes. Among all attributes, location was the least important attribute. Subgroup analysis showed that students who came from city or county and whose family income was more than RMB 50 000 (US$ 7396) were significantly willing to pay more monthly income for a job in city.ConclusionsThis study confirmed that economic and non-economic factors both affected the job choices of the students. These results may be more effective for policymakers to perfect the employment policies and design strategies to attract more nursing students taking jobs in rural areas.Electronic supplementary materialThe online version of this article (10.1186/s12960-018-0335-3) contains supplementary material, which is available to authorized users.
BackgroundThere is a deficiency of healthcare administrators in China as compared with other countries; furthermore, the distribution is unequal. To inform an effective policy intervention, it is crucial to understand healthcare administration students’ career decision-making. This study aims to investigate the undergraduate students’ stated preferences when choosing a job.MethodsA discrete choice experiment (DCE) was conducted among a population-based multistage sample of 668 final year undergraduate healthcare administration students during April to June 2017 in eight universities of China to elicit their job preferences. Attributes include location, monthly income, bianzhi (which refers to the established posts and can be loosely regarded as state administrative staffing), training and career development opportunity, working environment and workload. Conditional and mixed logit models were used to analyze the relative importance of job attributes.ResultsAll six attributes were statistically significant with the expected sign and demonstrated the existence of preference heterogeneity. Monthly income, workload and working environment were of most concern to healthcare administration students when deciding their future. Among the presented attributes bianzhi was of the least concern. Sub-group analysis showed that students who have an urban background and/or with higher annual family incomes were willing to pay more for working in the city. In addition, students from western and middle universities valued bianzhi higher than students from eastern universities.ConclusionsThis is the first study focusing on the career decision-making of Chinese healthcare administration students at a critical career decision-making point. Both monetary and non-monetary interventions could be considered by policy-makers to attract students to work in health institutions, especially in rural and remote health institutions in China. There exists preference heterogeneity on healthcare administration students’ job preferences, which should also be taken into account in developing more effective policy incentive packages.
Background: Preliminary evaluations have found that family doctor contract services (FDCSs) have significantly controlled medical expenses, better managed chronic diseases, and increased patient satisfaction and service compliance. In 2016, China proposed the establishment of a family doctor system to carry out contract services, but studies have found the uptake and utilization of these services to be limited. This study aimed to investigate rural residents' preferences for FDCSs from the perspective of the Chinese public. Methods: A discrete choice experiment (DCE) was performed to elicit the preferences for FDCSs among rural residents in China. Attributes and levels were established based on a literature review and qualitative methods. Five attributes, i.e., cost, medicine availability, the reimbursement rate, family doctor competence, and family doctor attitude, were evaluated using a mixed logit model. Results: A total of 609 residents were included in the main DCE analysis. The respondents valued the high competence (coefficient 2.44, [SE 0.13]) and the good attitude (coefficient 1.42, [SE 0.09]) of family doctors the most. Cost was negatively valued (coefficient − 0.01, [SE 0.01]), as expected. Preference heterogeneity analysis was conducted after adjusting the interaction terms, and we found that rural residents with higher educational attainment prefer a good attitude more than their counterparts with lower educational attainment. The estimated willingness to pay (WTP) for "high" relative to "low" competence was 441.13 RMB/year, and the WTP for a provider with a "good" attitude relative to a "poor" attitude was 255.77 RMB/year. Conclusion: The present study suggests that strengthening and improving the quality of primary health care, including the competence and attitudes of family doctors, should be prioritized to increase the uptake of FDCSs. The contract service package, including the annual cost, the insurance reimbursement rate and individualized services, should be redesigned to be congruent with residents having different health statuses and their stated preferences.
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