| OBSTACTThe purpose of this study is to use the discrete choice experiment to analyze the working preference of doctors and its influencing factors under the new public hospital personnel management environment,Understanding the effect intensity of each factor,and to provide policy suggestions for attracting and stabilizing the talent team of public hospitals and improving the working enthusiasm.MethodsIn this study,the theoretical analysis framework of influencing factors of doctors’ work preferences was constructed mainly by literature review and personal in-depth interview.Relevant influencing factors were selected by relevant theories,policies and literatures.Qualitative comparative analysis was used to verify the selected factors.Based on utility maximization,a discrete selection experiment is designed.We use the questionnaire to collect doctors’ working preferences related data.Descriptive statistical analysis is method is used to analysis the doctor’ personal information and mixed logit model is used to analyze the doctor work preferences influence factors and the factors influencing the group work preferences and the willingness to pay.Marginal effect model is used to analysis simulation scenario doctors work preferences.Results:Based on Maslow’s hierarchy of needs theory and Utility maximization theory,this study believes that doctors are rational people who have a variety of needs,and their preferences can meet their needs and maximize their own utility.Based on this,we construct a theoretical analysis framework of influencing factors and functions of doctors’ work preferences in public hospitals.A total of 250 questionnaires were issued in this study,among which 225 were valid.In the discrete selection model,the hybrid logit model is selected to analyze the data.The results of data analysis showed that the five influencing factors(monthly income,working hours,promotion opportunities of professional title,types of hospital and bianzhi,and location of work)has a statistically significant influence on doctors’ work preference.Among the non-economic attribute,the regression coefficient of types of hospital and bianzhi and working hours of public hospitals was large,which had the best influence on doctors’ work preference.The analysis results of willingness to pay showed that compare to level of "less chance of promotion" work,doctors were willing to pay an extra 5044.15 yuan(95%ci:3445.90-yuan-6642.41 yuan)in order to get ajob with more promotion opportunities..In terms of the types of hospital and bianzhi,compared with "no bianzhi in public hospitals",doctors are willing to pay 6238.85 yuan(95%ci:4108.94 yuan-8368.76 yuan)for ajob with traditional bianzhi in public hospitals,and 9690.58 yuan(95%ci:7534.23-11846.92 yuan)for a job in the filing system of public hospitals.In terms of working hours per week,doctors were willing to pay 9792.48 yuan(95%ci:7919.71－11 665.25)and 4867.18yuan(95%ci:3 062.66-6671.69)for " 40 hours or less working-hours"and,"50 hours or so," respectively,compared with "60hours or more working hours ".For the location of work,doctors were willing to pay 6263.00 yuan(95%ci:4643.76-7882.23)when offered ajob opportunity in the city,compared with "exurban".According to the stratified analysis,unmarried doctors had a significant preference for working hours,and they were willing to pay 13,809.30 yuan when the working hours changed to 40 hours or less per week.Married doctors have a higher preference for establishment,compared with "no bianzhi in public hospitals",doctors are willing to pay 10,537.13 yuan when the attribute change to the“filing system in public hospitals".Doctor with a bachelor or under degree prefer for working time than than a master doctor," 60 hours or more" for comparison,the week working hours turn to " 40 hours or less working hours,",the following doctor willingness to pay is 10551.21 yuan and 8954.21 yuan respectively;Doctor with a bachelor or under degree prefer for public hospital,the willingness to pay for "traditional bianzhi in public hospitals" and " filing system in public hospitals" is 14382.48 yuan and 11470.54 yuan respectively compare to "no bianzhi in public hospital ".Rural doctors in public hospitals prefer“filing system in public hospitals" higher,the willingness to pay is 11366.30 yuan.Doctors who be born in city grows higher preference about "working hours" attribute," 60 hours or more" for comparison,the week working hours to " 40 hours or less working hours“and“50 hours or so",their willingness to pay is 10506.27 yuan and 8418.46 yuan respectively.Different titles of doctors on preference’types of hospital and bianzhi" attribute differ,senior title of professional doctors in public hospitals have no statistical significance about "traditional bianzhi in hospital"l or "private hospital",intermediate title doctors in public hospital has higher preference about " traditional bianzhi in hospital" and“filing system in public hospitals",willingness to pay is 8622.62 yuan and.57.18.25 yuan respectively;different title doctors on the work site preference is different,compared with "exurban",primary、middle and senior title of professional doctors willingness to.pay about "working in city" is 3804.268 yuan.8940.45 yuan and 10693.88 yuan respectively.Different type bianzhi doctor have different preferences about "chance of promotion" and "working hours weekly",as for"chance of promotion",compare to " less chance of promotion" less traditional bianzhi doctors and no bianzhi doctors’willingness to pay is 6331.54 yuan and 4179.19 yuan to "more chance of promotion" work respectively,the week working hours turns from "60 hours or more working hours" to" 40 hours or less working hours",traditional bianzhi doctors and no bianzhi doctors’ willingness to pay is 11052.44 yuan and 8016.796 yuan respectively.Analysis on the marginal effect when change the attributes level of the work how doctor preferences will be changed,we found that:with the benchmark conditions(monthly income is 10000 yuan,less chance promotion,no bianzhi in public hospitals,for 60 or more working hours a week,working location in the suburbs),compared to the month income rose to 40000 yuan and 30000 yuan respectively while other condition is constant,the doctor work preferences will be increased by 58.74%and 41.15%respectively;when working hours were adjusted from "60 hours a week or more" to "40 hours a week or less",all else being equal,doctors’work preferences increased by 19.7 percent.Conclusions and Suggestions:Economic factors(monthly income)and non-economic factors(working hours,chance of promotion,types of hospital and bianzhi,location of work)have a significant impact on doctors’ work preference.Higher monthly income,easier work,and "filing system in public hospitals positions are the most attractive to doctors.The working preference of doctors with different marital status,educational background,household registration status,professional title status and staffing status varies.Therefore,managers should adopt policies that combine economic incentive and non-economic incentive to meet the needs of different tvpes of doctors.Based on the above conclusions,the Suggestions of this study are as follows:first,multiple measures should be taken to improve the job satisfaction and stability of doctors;Second,a scientific and reasonable compensation mechanism should be established.The third is to establish a suitable professional title promotion system;Fourth,hospitals should consider the social background of different population when recruiting staff.Fifth,to provide more systematic and standardized vocational skills training for medical staff to reduce work pressure;Sixth,to publicize policies to medical staff,increase doctors’ acceptance of policies,and enhance the internal cohesion of hospitals. |
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