Factors Influencing Medical Personnel to Work in Primary Health Care Institutions: An Extended Theory of Planned Behavior.

Huanhuan Jia,Jianxing Yu,Liangwen Ning,Xihe Yu,Tianyu Feng,Peng Cao,Shang Gao,Panpan Shang

doi:10.3390/ijerph19052785

Abstract

In China, the primary health care institutions (PHCIs) have difficulty winning the trust of residents because of the shortage of medical personnel and the low level of skills. The government has advocated encouraging qualified doctors to work in PHCIs, but no obvious results are achieved. Based on the theory of planned behavior (TPB), this paper explores the factors affecting medical personnel seeking employment in PHCIs and then putting forward measures to improve the human resources construction of PHCIs. A three-stage survey was conducted to obtain the factors and a structural equation modeling (SEM) was applied to examine the relationship of the factors. We found that the factors affecting medical personnel to work in PHCIs include the specific conditions and work contents of PHCIs, as well as the family life and regional factors. Besides, there is a significant correlation and indirectness between these factors. Therefore, targeted measures can be proposed to improve the intention of medical personnel seeking employment in PHCIs. This study provides theoretical support for encouraging medical personnel to work in PHCIs and improving the primary health care system.

Highlights

Primary health care (PHC) is the most inclusive, equitable, cost-effective, and efficient approach to enhancing people’s physical and mental health, as well as their social wellbeing, and it is the cornerstone of a sustainable health system that can achieve universal health coverage, reach sustainable health-related development goals, and promote health security [1]
We found that the factors can be summarized into 6 factors, including condition of the city where the primary health care institutions (PHCIs) is located (CCPL), remuneration and development (RD), internal organization development (IOD), job responsibilities (JR), family support (FS) and sense of gain (SG)
The results show that family members are an important social group that influences the intention of medical personnel to work in PHCIs, which is consistent with the Chinese tradition of attaching importance to family culture

Summary

Introduction

Primary health care (PHC) is the most inclusive, equitable, cost-effective, and efficient approach to enhancing people’s physical and mental health, as well as their social wellbeing, and it is the cornerstone of a sustainable health system that can achieve universal health coverage, reach sustainable health-related development goals, and promote health security [1]. As a country with a large population and vast territory, China’s primary health care services play a vital role in improving the fairness and accessibility of health services in general. Primary health care services are provided by primary health care institutions (PHCIs), mainly including community health service centers and township hospitals [2]. Poor-quality health care delivered by providers in PHCIs is a main challenge to China’s achievement of UHC, and improving the primary health care system remains a central part of China’s health-care reform [7]

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Discussion

Conclusion