Motivating factors on performance of primary care workers in China: a systematic review and meta-analysis

Abstract

ObjectiveAlthough China has made remarkable progress in strengthening its primary healthcare system, lack of well-performed primary health workforce is still the bottleneck of deepening the reform. The objective of this review is to understand the current profile of Chinese primary care workers (PCWs) and their motivating factors of performance and propose targeted policy suggestions on improving their work performance.DesignSystematic review.MethodsA systematic search of PubMed and MEDLINE was conducted to identify articles published from January 1, 2000, to June 2, 2018. Quality assessment and data extraction for the studies closely relevant to performance of PCWs in China were conducted by two reviewers independently. A preliminary framework containing different levels of factors influencing PCWs’ motivation based on existence, growth and relatedness (ERG) theory guided the synthesis analysis. In addition, we used a random-effects model to pool individual studies on job satisfaction and estimate the overall job satisfaction of PCWs.ResultsA total of 36 articles were included; 16 (23 882 participants) in the meta-analysis. Regarding the individual level of motivation, 3 overarching themes and 12 subthemes were developed. The subthemes of financial incentives, career advancement and work itself were frequently mentioned and have more influences on PCWs’ performance. Moreover, the healthcare system reform policies have inevitable and complex impacts on different levels of human needs, and then influences on the motivation and performance of PCWs. Meta-analysis showed that the overall job satisfaction score among PCWs was 3.30, just reaching a satisfied rating and varied in different regions.ConclusionsThis study suggests low work satisfaction among PCWs in China, with financial incentives and career advancement being two most important motivating factors. Efforts to improve the work performance in PCWs should give priority to these motivating factors and systematically take into account the health policy’s impacts on performance of PCWs.

Association between direct government subsidies and service scope of primary care facilities: a cross-sectional study in China

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Turnover intention among primary health workers in China: a systematic review and meta-analysis

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Job burnout and turnover intention among Chinese primary healthcare staff: the mediating effect of satisfaction

“…4 Results of a survey show that from 2010 to 2016, the proportion of Chinese primary healthcare staff decreased from 44% to 33%. 5 Moreover, the average turnover rate of nurses in first-class tertiary hospitals is 5.8% in China, which goes up to 8%-10% in economically…”

“… 4 Results of a survey show that from 2010 to 2016, the proportion of Chinese primary healthcare staff decreased from 44% to 33%. 5 Moreover, the average turnover rate of nurses in first-class tertiary hospitals is 5.8% in China, which goes up to 8%–10% in economically advanced regions like Shanghai and Guangzhou. 6 Under this circumstance, the turnover intention has been an important and popular study subject in psychology and management field.…”