Satisfaction of Township Hospitals Health Workers on How They Are Paid in China

Background: Township Hospitals (THs) are crucial providers in China’s primary health delivery system. Low job satisfaction of THs health workers has been one of biggest challenges to strengthening the health system in China. Even huge amounts of studies confirmed low remuneration level as a key demo...

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Autores principales:	Beibei Yuan, Yahang Yu, Hongni Zhang, Huiwen Li, Chen Kong, Wei Zhang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	job satisfaction payment primary health workers Medicine R
Acceso en línea:	https://doaj.org/article/e47462e01e5f49afadcd507ac3dd560b
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spelling	oai:doaj.org-article:e47462e01e5f49afadcd507ac3dd560b2021-11-25T17:49:59ZSatisfaction of Township Hospitals Health Workers on How They Are Paid in China10.3390/ijerph1822119781660-46011661-7827https://doaj.org/article/e47462e01e5f49afadcd507ac3dd560b2021-11-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/22/11978https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601Background: Township Hospitals (THs) are crucial providers in China’s primary health delivery system. Low job satisfaction of THs health workers has been one of biggest challenges to strengthening the health system in China. Even huge amounts of studies confirmed low remuneration level as a key demotivating factor though few studies have explored the feelings of health workers on how they were paid. Objective: To analyze how the key design of Performance-based Salary System (PBS) influences the satisfaction of health workers on the payment system in China’s THs. Method: A cross-sectional study was conducted in 47 THs in Shandong China, and a total of 1136 participants were recruited. Expectancy theory was applied to design the measurements on designs of PBS. The associations between PBS design and satisfaction of health workers were analyzed by logistic regression. Results: Three key components of PBS design were all related to the satisfaction of health workers. Those health workers who were aware of assessment methods were more likely to be satisfied with how they were paid (OR = 2.44, <i>p</i> < 0.001) compared with those being not aware of the methods. The knowledge on personal performance was also associated with being satisfied (OR = 3.34, <i>p</i> < 0.001). The percentage of floating income in total income was negatively associated with the satisfaction, and one percentage point increase in floating income proportion could result in the possibility of being satisfied decreasing by 2.82% (95%CI −4.9 to −0.7, <i>p</i> = 0.01). Subgroup analysis found that only in those with lower value on monetary income, the negative influence of more floating income was significant. Conclusions: When policymakers or managers apply performance-related payment to incentivize certain work behavior, they should pay attention to the design details, including keeping transparency in the performance assessment criteria, clear performance feedback, and setting the proportion of the performance-related part based on the preference of health workers in certain cultural settings.Beibei YuanYahang YuHongni ZhangHuiwen LiChen KongWei ZhangMDPI AGarticlejob satisfactionpaymentprimary health workersMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11978, p 11978 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	job satisfaction payment primary health workers Medicine R
spellingShingle	job satisfaction payment primary health workers Medicine R Beibei Yuan Yahang Yu Hongni Zhang Huiwen Li Chen Kong Wei Zhang Satisfaction of Township Hospitals Health Workers on How They Are Paid in China
description	Background: Township Hospitals (THs) are crucial providers in China’s primary health delivery system. Low job satisfaction of THs health workers has been one of biggest challenges to strengthening the health system in China. Even huge amounts of studies confirmed low remuneration level as a key demotivating factor though few studies have explored the feelings of health workers on how they were paid. Objective: To analyze how the key design of Performance-based Salary System (PBS) influences the satisfaction of health workers on the payment system in China’s THs. Method: A cross-sectional study was conducted in 47 THs in Shandong China, and a total of 1136 participants were recruited. Expectancy theory was applied to design the measurements on designs of PBS. The associations between PBS design and satisfaction of health workers were analyzed by logistic regression. Results: Three key components of PBS design were all related to the satisfaction of health workers. Those health workers who were aware of assessment methods were more likely to be satisfied with how they were paid (OR = 2.44, <i>p</i> < 0.001) compared with those being not aware of the methods. The knowledge on personal performance was also associated with being satisfied (OR = 3.34, <i>p</i> < 0.001). The percentage of floating income in total income was negatively associated with the satisfaction, and one percentage point increase in floating income proportion could result in the possibility of being satisfied decreasing by 2.82% (95%CI −4.9 to −0.7, <i>p</i> = 0.01). Subgroup analysis found that only in those with lower value on monetary income, the negative influence of more floating income was significant. Conclusions: When policymakers or managers apply performance-related payment to incentivize certain work behavior, they should pay attention to the design details, including keeping transparency in the performance assessment criteria, clear performance feedback, and setting the proportion of the performance-related part based on the preference of health workers in certain cultural settings.
format	article
author	Beibei Yuan Yahang Yu Hongni Zhang Huiwen Li Chen Kong Wei Zhang
author_facet	Beibei Yuan Yahang Yu Hongni Zhang Huiwen Li Chen Kong Wei Zhang
author_sort	Beibei Yuan
title	Satisfaction of Township Hospitals Health Workers on How They Are Paid in China
title_short	Satisfaction of Township Hospitals Health Workers on How They Are Paid in China
title_full	Satisfaction of Township Hospitals Health Workers on How They Are Paid in China
title_fullStr	Satisfaction of Township Hospitals Health Workers on How They Are Paid in China
title_full_unstemmed	Satisfaction of Township Hospitals Health Workers on How They Are Paid in China
title_sort	satisfaction of township hospitals health workers on how they are paid in china
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/e47462e01e5f49afadcd507ac3dd560b
work_keys_str_mv	AT beibeiyuan satisfactionoftownshiphospitalshealthworkersonhowtheyarepaidinchina AT yahangyu satisfactionoftownshiphospitalshealthworkersonhowtheyarepaidinchina AT hongnizhang satisfactionoftownshiphospitalshealthworkersonhowtheyarepaidinchina AT huiwenli satisfactionoftownshiphospitalshealthworkersonhowtheyarepaidinchina AT chenkong satisfactionoftownshiphospitalshealthworkersonhowtheyarepaidinchina AT weizhang satisfactionoftownshiphospitalshealthworkersonhowtheyarepaidinchina
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Satisfaction of Township Hospitals Health Workers on How They Are Paid in China

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