Effect of healthcare system reforms on job satisfaction among village clinic doctors in China

Abstract

Background Village clinic doctors (VCDs) are part of the health service force in rural China. VCDs’ job satisfaction (JS) is important to the stability of the three-tiered health service system. Since 2009, the Chinese government launched a new health care system reform (NHCSR) which affected VCDs significantly. This study aimed to analysing the effect of NHCSR on JS among VCDs. Methods All the data came from three surveys in Shandong Province conducted in 2012, 2015 and 2018. In 2012, an originally designed questionnaire was used to conduct a baseline survey of 405 VCDs from 27 townships in nine counties. In 2015 and 2018, 519 and 223 VCDs in the same counties were surveyed with the same questionnaire. Descriptive analysis and ANOVA were used to analyse the level and changes in VCDs’ JS. Results The mean scores of VCDs’ total JS were 2.664 ± 1.069, 3.121 ± 0.931 and 2.676 ± 1.044 in 2012, 2015 and 2018, respectively, with a significant difference (F = 28.732, P < 0.001). The mean scores of the medical practice environment and the job itself showed a continuous downward trend. The trends of the mean scores for job reward, internal work environment and organizational management were consistent with the trend for total JS. Conclusion The NHCSR had a partly negative impact on VCDs’ JS. Policy-makers should pay more attention to VCDs’ job reward and medical practice environment. With the implementation of new reform policies, VCDs’ JS should be the subject of more systematic and detailed research.

Global Insights Into Rural Health Workers' Job Satisfaction: A Scientometric Perspective

“…A recent meta-analysis indicated that the prevalence of turnover intention of rural primary healthcare workers was about 23.4%−42.1% (28). Other studies had also shown the low job satisfaction of RHWs in China (1,2,31,32). From the existing research, both of them had become an important reason to aggravate the occurrence of turnover behaviors.…”

“…A number of studies directed at RHWs in China also supported that motivation and job satisfaction were inseparable. Under the condition of insufficient objective resources, strong motivation was an important subjective condition to improve job satisfaction and reduce turnover intention (2,14,31,32,(36)(37)(38).…”

“…Another study directed at rural nurses in Brazil had shown that working conditions, infrastructure, forms of access to the workplace, and distance from the decision center were factors that stood out as difficulties of work, and they were also key factors affecting job satisfaction (44). In addition, some studies on Chinese village doctors also found that various indicators of the working environment were important factors affecting job satisfaction (2,31,32,37,45). However, in the context of the COVID-19 pandemic, there were few studies on the impact of the work environment on job satisfaction, especially in developing countries.…”

Systematic and meta-based evaluation on job satisfaction of village doctors: An urgent need for solution issue

“…The type of review studies, documents with inconsistent research objects, and incomplete data information were excluded by reading the full text. Finally, 37 studies (2, 3, 5, 8, [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] were included for all dimensions of job satisfaction analysis. Among them, 25 studies were used to evaluate the overall score of job satisfaction (refer to Figure 1 for the detailed process).…”

“…On one hand, scholars are more interested in the evaluation of the current situation or influencing factors of job satisfaction (9,(14)(15)(16)(17)(18), and there are more relevant studies on health workers in urban public hospitals rather than village doctors. On the other hand, different studies may use different methods to evaluate job satisfaction: some scholars directly put forward the concept of overall job satisfaction (19)(20)(21)(22)(23)(24), while others (25-28) reported their job satisfaction in multidimensional items (including income satisfaction, work environment satisfaction, and leadership satisfaction). In addition, different surveys reported diverse evaluation scales with several parts in the form of satisfaction distribution (29)(30)(31)(32)(33) and others in the form of scores (19-22, 24, 34).…”