Exploring employment preferences of nurses to improve retention in rural China

Abstract

BackgroundThe scarcity of nurses in rural China deserves serious consideration in light of the widening gap in health outcomes between rural and urban populations. The outflow of primary care nurses suggests the value of examining their employment preferences to identify possible effective incentives for their retention. MethodsOur research used discrete choice experiment methodology designed to quantitatively measure the relative importance of various job attributes valued by primary care nurses using conditional logit and mixed logit models. Willingness to pay and uptake rates were also calculated. ResultsA total of 1744 registered nurses in township health centres were surveyed. Participants considered all the job attributes included in the study to be significant, with pay increases demonstrating the greatest potential to improve the retention of nurses. Among the non-monetary aspects of work, nurse–patient relationships, bianzhi (positions allocated to each unit by the Chinese government with special benefits) and educational opportunities ranked highest in importance for respondents. Responses to hypothetical policy proposals suggest that incentive packages are also likely to be effective. ConclusionsPolicy making regarding rural nurses' retention is an important undertaking that requires an evidence-based approach. Our findings provide a range of policy options that shed light on effective retention strategies. Tailoring policy incentives to primary care nurses is also necessary.