A Study On Satisfaction Of Incentive Factors In Attracting And Maintaining Health Human Resources In Western China

Background:At present,China faces the challenges of the shortage of health human resources,the quality is not high and the allocation is not unreasonable,the problem in the western poverty and rural areas where economy is underdeveloped is more obvious.With the rapid increase in the prevalence of chronic diseases in recent years,the demand for medical and health services of urban and rural residents in China has continued to increase,between which and the uneven distribution of health resources form a huge tension.The construction of health personnel in the underdeveloped grassroots areas in western China is lagging behind,the number of health personnel is small,the quality is low,the layout and structure are unreasonable,the incentive mechanism such as attracting and retaining is not perfect,hinder the process of equalization of basic public health services in China and the realization of health and well-being of the people.Based on this,it is necessary to study the factors that affect the attraction and retention of health human resources in western China from the perspective of satisfaction.Objective:The purpose of this study is to construct incentive factor satisfaction measure index to evaluate the satisfaction status of health human resources in the western region.Quantitative data are used to understand the overall level of the satisfaction and the distribution ratio of each index,and analyze whether there is any difference in satisfaction of the different characteristics’ health personnel,and finally combined with the qualitative interviews analyze the influencing factors of the satisfaction,further summarize the status quo of health human resources satisfaction in the western region and put forward feasible countermeasures and suggestions.Methods:This study uses the descriptive analysis method to analyze the health human resources profile in western sample provinces,and the incentive factors based on satisfaction are constructed by literature review and expert consultation,and the satisfaction index was divided into six large dimensions by cluster analysis.The results of satisfaction were evaluated by using the ratio analysis,single factor analysis of variance,t test and Pearson’s correlation analysis.The qualitative method of personal in-depth interview is used to analyze the incentive factors that attract and maintain the western health workers.Results:1.Through the literature review and expert consultation to build a satisfaction scale indicators,namely,"your existing knowledge level","monthly salary","medical work on-the-job training","participate in academic research opportunities","technical titles promotion "," career development opportunities "," your hospital leadership and management capacity " and other 29 indicators;2.The method of cluster analysis divides the scale index into six dimensions: job return,work itself,personal development,working relationship,leadership ability,working environment;3.Quantitative research results of four sample provinces’ incentive factor satisfaction analysis: The data of distribution proportion of the four provinces’ survey object among the satisfaction levels showed that the five indicators with the highest satisfaction were "the relationship between colleagues","the recognition of your work at your superiors","the recognition of your colleagues for your work"," your harmony with the patient ","local climate",the five indicators with the lowest score of satisfaction are "monthly allowance","holiday","monthly salary" and so on;the satisfaction of the indicators score has a difference in different levels of medical institutions,between different provinces,between different titles and between different qualifications;4.Qualitative interview results further confirm the problems exist in health resources in the western region,including: the lack of health personnel,township and village health institutions more scarce talent,and the introduction is difficult,loss is serious,attract and retain mechanism is poor;Staff income and pay is not proportional,the high work pressure;permanent staff system behind;government’s management system on the hospital is rigid;promotion is limited in township and county level hospital.Suggestions:1.Treating the village doctor: give them a professional identity;improve treatment;increase training opportunities;2.About the township hospitals: a reasonable set of preparation,to achieve fair pay;to lift the title promotion restrictions;reform management system;3.About the county hospital: to achieve equal pay for equal work;increase training opportunities;break the title promotion restrictions;coordination of multiple supervision and "policy traffic congestion";4.Adjusting the policy moderately,tilt to the grassroots level;5.Innovating the training mode of medical talents in the poverty-stricken areas;6.Harmonizing the contradiction between health workforce policy and other relevant policies;7.Do a good job of medical ethics’ propaganda.