Abstract
BackgroundHigh turnover among general practitioners (GPs) is a significant challenge in China’s efforts to build a sustainable, effective primary care system, but little data is available to help understand and address this issue. The study was aiming at assessing the intention to leave their posts among a sample of GPs and investigating associated factors.MethodsA cross-sectional survey was conducted between December 12, 2014 and March 10, 2015 in Hubei Province, Central China. A total of 1016 GPs (response rate, 85.67%) were investigated by using a structured self-administered questionnaire. A generalized linear regression model was used to identify the associated factors with turnover intention among GPs.ResultsBased on a full score of 24, the average score for GPs’ turnover intention was 15.40 (SD = 3.43). 78.35% of the GPs had a moderate or higher level of turnover intention. Six hundred and thirty one (62.37%) GPs had ever been exposed to abuse of any kind (physical assault, 18.92%; verbal abuse, 54.38%; threat, 33.79%; verbal sexual harassment, 22.66%; and physical sexual harassment, 7.59%). Generalized linear regression analysis indicated that GPs who were male; who had a vocational school or higher; who had a temporary work contract; who were with lower level of job satisfaction; who reported higher scores on emotional exhaustion; who had been exposed to higher frequency of workplace violence were expressed higher intention to leave their present positions.ConclusionThis study shows that GP’s intention to leave general practices is high in Hubei, China. In addition, the prevalence of workplace violence is high among GPs, particularly in the verbal abuse and threat. Measures such as offering permanent contract status, increasing overall job satisfaction, and improving doctor-patient relationship, are needed to moderate GP’s turnover intention in order to maintain the foundation of China’s three-tier health system.
Highlights
High turnover among general practitioners (GPs) is a significant challenge in China’s efforts to build a sustainable, effective primary care system, but little data is available to help understand and address this issue
Study population and sampling A cross-sectional study was conducted between December 12, 2014 and March 10, 2015 in Wuhan, Hubei Province (Central China).These GPs worked in Community health center (CHC) in urban and Township health center (THC) in rural areas
Those GPs who were male; who had a vocational school or higher; who had a temporary work contract; who were with lower level of job satisfaction; who reported higher scores on the Emotional exhaustion (EE); who had been exposed to higher frequency of workplace violence were more likely to show the intention to leave their present position
Summary
General practitioners (GPs) are the foundation of any primary healthcare system They are the main providers of community health service (CHS), providing a wide range of health services and managing referrals to specialist care and hospitals. Many efforts were taken to strengthen the establishment and expand the supply of primary health workers, especially in the training and recruitment of GPs [4].Primary healthcare workers has achieved the attention and support from the government, leaders and related scholars, and the building of GPs team made an some great progress, in China, primary health institutions (community health centers (CHCs) and township health centers (THCs)) have been facing ongoing challenges in the shortage of human resources and turnover of on-post GPs. According to the China Health Statistics Yearbook in 2013, the proportion of GPs among registered physicians was 4.2% [5], which was lower than the level ranging from 30% to 60% of western countries [6, 7]. According to the development planning of Chinese healthcare systems [8], in 2020, two to three GPs per 10,000 population will be fitted in the healthcare system in providing care to people at different levels in China
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