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

He, Rongxin; Liu, Jinlin; Zhang, Wei Hong; Zhu, Bin; Zhang, Ning

doi:10.1136/bmjopen-2020-037117

Cited by 62 publications

(88 citation statements)

References 55 publications

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“…Increasing turnover intention among healthcare workers in the era of the COVID-19 pandemic has been of intense concern in China and countries badly impacted by the COVID-19 pandemic [ 9 , 14 ]. In China, the healthcare system was challenged by a shortage of medical doctors even before the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, the socio-economic variables did not significantly predict turnover intention in the multivariable analysis, however, turnover intention was significantly higher among participants from rural and lower household monthly income in the univariable analysis. Remuneration is negatively associated with turnover intention in most industries, likewise in healthcare services [ 14 ]. Students from lower socio-economic backgrounds exhibited higher turnover intention perhaps due to a desire for a higher paid profession.…”

Section: Discussionmentioning

confidence: 99%

“…Findings of a recent systematic review across 15 countries revealed immense mental health problems facing healthcare workers, including depression, anxiety, acute stress reaction, post-traumatic stress disorder, insomnia and occupational burnout throughout the pandemic [ 12 ]. In addition to work-related psychological consequences and fear of contagion, in China, the lack of social recognition and social status of medical doctors and low remuneration were found to be additional factors resulting in poor job satisfaction and turnover intention [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Effect of the COVID-19 Pandemic on Medical Student Career Perceptions: Perspectives from Medical Students in China

Cai

Lin

Alias

et al. 2021

IJERPH

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Our aim was to examine perceived occupational turnover intentions among medical students and the associated factors. A cross-sectional study using a Web-based survey was conducted. A total of 2922 completed responses were received (response rate 55.7%). A total of 58.4% (95% CI 56.6–60.2) reported high turnover intention (score of 7–15). The odds of higher total turnover score among the fifth-year students was nearly four times that of first-year students (OR = 3.88, 95% CI 2.62–5.73). Perception of the medical profession as not being of high social status and reputation significantly influenced high turnover intention scores (OR = 2.26, 95% CI 1.90–2.68). All three dimensions of the multidimensional scale of perceived social support (MSPSS) significantly predict turnover intention. Lower scores in the support from Significant Other (OR = 1.47, 95% CI 1.17–1.84), Family (OR = 1.47, 95% CI 1.18–1.83) and Friend (OR = 1.42, 95% CI 1.14–1.77) subscales were associated with higher turnover intention. Low score in the Brief Resilience Scale (BRS) was also associated with higher turnover intention (OR = 1.44, 95% CI 1.17–1.77). The findings shed light on the importance of changing public attitudes towards respecting the medical profession and improving the implementation of policies to protect the well-being of people in the medical profession.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of the COVID-19 Pandemic on Medical Student Career Perceptions: Perspectives from Medical Students in China

Cai

Lin

Alias

et al. 2021

IJERPH

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“…The primary health care system has been significantly improved following its reform since 2003. Nevertheless, challenges remain, including frequent staff turnover [81], and the CDC system, created in 2003 with a goal to strengthen the public health service, struggles to maintain the necessary levels of technical expertise. Between 2003 and 2018, the number of personnel and professionals reduced by 10.6 and 12.2%, respectively, for various reasons, including low salary [82].…”

Section: Challenges To Maintaining Malaria-free Statusmentioning

confidence: 99%

Seven decades towards malaria elimination in Yunnan, China

Zhou

et al. 2021

Malar J

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Background Yunnan Province was considered the most difficult place in China for malaria elimination because of its complex malaria epidemiology, heterogeneous ecological features, relatively modest economic development, and long, porous border with three malaria endemic countries: Lao People’s Democratic Republic, Myanmar, and Viet Nam. Methods Academic publications and grey literature relevant to malaria elimination in Yunnan covering the period from 1950 until 2020 inclusive were considered. The following academic indexes were searched: China Science Periodical Database, China National Knowledge Infrastructure Database, and MEDLINE. Grey literature sources were mainly available from the National Institute of Parasitic Diseases (NIPD), the Chinese Center for Diseases Control and Prevention, and the Yunnan Institute of Parasitic Diseases (YIPD). Results A malaria elimination campaign in the 1950–1960s, based mainly on mass administration of antimalarial drugs and large-scale vector control, reduced morbidity and mortality from malaria and interrupted transmission in some areas, although elimination was not achieved. Similar strategies were used to contain outbreaks and a resurgence of disease during the 1970s, when malaria services were discontinued. From the 1980s, malaria incidence declined, despite the challenges of large numbers of mobile and migrant populations and an unstable primary health care system in rural areas following economic transformation. Launch of the national malaria elimination programme in 2010 led to adoption of the ‘1–3-7′ surveillance and response strategy specifying timely detection of and response for every case, supported by the establishment of a real-time web-based disease surveillance system and a new primary health care system in rural areas. Border malaria was addressed in Yunnan by strengthening the surveillance system down to the lowest level, cross-border collaboration with neighbouring countries and non-governmental organizations, and the involvement of other sectors. Conclusions Seven decades of work to eliminate malaria in Yunnan have shown the importance of political commitment, technically sound strategies with high quality implementation, a robust surveillance and response system at all levels, community participation and effective management of border malaria. The experiences and lessons learned from elimination remain important for prevention re-establishment of malaria transmission in the Province.

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“…For medical personnel, the investment of time and money and the difficulty of obtaining a professional title [ 50 ] make them sensitive to remuneration and development issues. In addition, previous studies [ 26 , 54 , 55 ] have reported that remuneration and development are also important factors that affect the work satisfaction and enthusiasm of community health workers. Therefore, we recommended that the sense of gain of medical personnel seeking employment at PMHCIs can be increased through appropriate remuneration and development opportunities.…”

Section: Investigationmentioning

confidence: 99%

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

Jia

Cao

et al. 2021

IJERPH

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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.

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

Cited by 62 publications

References 55 publications

Effect of the COVID-19 Pandemic on Medical Student Career Perceptions: Perspectives from Medical Students in China

Effect of the COVID-19 Pandemic on Medical Student Career Perceptions: Perspectives from Medical Students in China

Seven decades towards malaria elimination in Yunnan, China

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

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