This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Xihe Yu
Jilin University School of Public Health
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4151-0915
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: In China, primary health care is rarely utilized because of medical personnel shortages at primary medical and health care institutions (PMHCIs). Several studies suggest that the most effective solution is to guide qualified doctors and medical graduates to work in PMHCIs, but the studies and measures have been formulated only from the perspective of the government and PMHCIs; few have considered the subjective willingness of medical personnel.
Methods: From the perspective of the guided objects, this research was divided into two parts based on implicit theory and a lexical method. The first part takes hospital clinical graduates and interns as the survey subjects and collects the factors affecting their choosing PMHCIs for employment. The second part takes candidates for the medical licensing examination as the survey object and uses exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation modeling (SEM) to explore the dimensions and paths of the influencing factors.
Results: Seven factors were obtained from the EFA, and the SEM hypothesis fits the data well. Internal Organization Development, Patient Factor, Remuneration and Development, and Family Support had a significantly positive effect on the Sense of Gain of medical personnel seeking employment at PMHCIs, whereas both Job Responsibilities and Condition of the City Where the PMHCI Is Located had no significant effect. In addition, the indirect effects of Internal Organization Development and Condition of the City Where the PMHCI Is Located on the Sense of Gain were significant. The Patient Factor, Family Support, and Remuneration and Development significantly mediated the relationship between the internal and external environment of the institution and the Sense of Gain, whereas the mediating effect of Job Responsibilities was not significant.
Conclusions: The improvement of family support, remuneration and development and patient factors increases the willingness of medical personnel to seek employment at PMHCIs. In addition, the internal and external environments of a PMHCI play a vital role in guiding medical personnel to PMHCIs for employment. This research provides theoretical support for improving the development of human resources, guiding medical personnel to work in PMHCIs, and promoting the implementation of medical and health system reform in China.
Keywords
Health Workforce, Primary Medical and Health Care Institution, Implicit Theory, Lexical Methods
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Xihe Yu
Jilin University School of Public Health
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4151-0915
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 23 Feb, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: In China, primary health care is rarely utilized because of medical personnel shortages at primary medical and health care institutions (PMHCIs). Several studies suggest that the most effective solution is to guide qualified doctors and medical graduates to work in PMHCIs, but the studies and measures have been formulated only from the perspective of the government and PMHCIs; few have considered the subjective willingness of medical personnel.
Methods: From the perspective of the guided objects, this research was divided into two parts based on implicit theory and a lexical method. The first part takes hospital clinical graduates and interns as the survey subjects and collects the factors affecting their choosing PMHCIs for employment. The second part takes candidates for the medical licensing examination as the survey object and uses exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation modeling (SEM) to explore the dimensions and paths of the influencing factors.
Results: Seven factors were obtained from the EFA, and the SEM hypothesis fits the data well. Internal Organization Development, Patient Factor, Remuneration and Development, and Family Support had a significantly positive effect on the Sense of Gain of medical personnel seeking employment at PMHCIs, whereas both Job Responsibilities and Condition of the City Where the PMHCI Is Located had no significant effect. In addition, the indirect effects of Internal Organization Development and Condition of the City Where the PMHCI Is Located on the Sense of Gain were significant. The Patient Factor, Family Support, and Remuneration and Development significantly mediated the relationship between the internal and external environment of the institution and the Sense of Gain, whereas the mediating effect of Job Responsibilities was not significant.
Conclusions: The improvement of family support, remuneration and development and patient factors increases the willingness of medical personnel to seek employment at PMHCIs. In addition, the internal and external environments of a PMHCI play a vital role in guiding medical personnel to PMHCIs for employment. This research provides theoretical support for improving the development of human resources, guiding medical personnel to work in PMHCIs, and promoting the implementation of medical and health system reform in China.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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