Workload and job satisfaction of rural doctors during the new healthcare reform in China: a cross-sectional mixed methods study

2021 ◽  
Author(s):  
Xiangshu Dong ◽  
Baodan Liu ◽  
Xiang Xiao ◽  
Huawei Han
Keyword(s):  
Public Health ◽  
Job Satisfaction ◽  
Mixed Methods ◽  
Health Services ◽  
Healthcare Reform ◽  
Public Hospitals ◽  
Public Health Services ◽  
Cross Sectional ◽  
Clinical Visit ◽  
Visit Number

Abstract Background With the integration of urban and rural health insurance, the demand for health services from rural residents increases rapidly, which in turn, bring heavier workload for doctors from county public hospitals (CPHs). Meanwhile, township healthcare centers (THCs) are required to provide more additional public health services under the integration of public health and primary care, which also brings challenges for its doctors’ workload. As a result, Chinese rural doctors from both CPHs and THCs have to cope with heavier workload that may have an adverse effect on their job satisfaction. This study sought to investigate the association between the workload and their job satisfaction during the new healthcare reform in China. Methods A cross-sectional survey using mixed methods targeting Chinese rural doctors from both CPHs and THCs in three provinces of Gansu (the west province of China), Shanxi (the middle province of China), and Shandong (the east province of China) was conducted. Correlation analyses of three dimensions of workload and job satisfaction were performed. The association between workload and job satisfaction was estimated using discrete choice regression and the detail parts of workload were analyzed using qualitative data collected from interviews with some agency administrators and representatives from the respondents. Results Of the 849 rural doctors enrolled, 52.18% thought that the proportion of time spent on non-medical activities (PT) was too high; 78% reported that they worked more than 8 hours in a working day; up to 40% of rural doctors from county public hospitals (CPHs) reported unaffordable clinical visit number per day (CV), which was significantly higher than that from township healthcare centers (THCs). Both of the proportion of time on non-medical issues and working hours (WH) were significantly and negatively associated with the job satisfaction of rural doctors. However, the effects of clinical visit number were mixed, with a significantly negative association with the job satisfaction of doctors from CPHs rather than from THCs. Qualitative analysis indicated that non-medical activities constituted the main source of Chinese rural doctors workload, in terms of a performance assessment criteria for doctors from CPHs and public health services for doctors from THCs. Conclusion The workload, dominated by non-medical activities, working hour and clinical visit number, are non-negligible factors that negatively associated with Chinese rural doctors’ job satisfaction in the healthcare reform setting. The growing number of patients towards CPHs and the additional public health service imposed on the THC doctors were the main source for the workload that worsened rural doctors’ job satisfaction. Policy makers should consider some feasible measures to reduce non-medical activities for rural doctors so that they could dedicated their limited energy and time to the medical service.

scholarly journals Report of “Satisfaction” survey amongst Public Health Services Nurses in Port Said.

2020 ◽  
Author(s):  
Saverio Bellizzi ◽  
Susanna Padrini
Keyword(s):  
Public Health ◽  
Job Satisfaction ◽  
Health Services ◽  
Work Load ◽  
Health Care Facilities ◽  
Clinical Environment ◽  
Public Health Services ◽  
Healthcare Provision ◽  
Cross Sectional ◽  
Port Said

Abstract BACKGROUND: There is a paucity of evidence regarding nurses’ experience in different areas of Egypt. A previous pilot unpublished study conducted in the Port Said Technical Nursing Institute, and based on 36 participants, showed almost half of nurses satisfied with their job, as well as salary and work-load as main reason for dissatisfaction as the main problems. We explored job satisfaction of nurses working in public health services of the Port Said Governorate and inform future healthcare provision and policy.METHODS: A Cross sectional study including nurses of different Units was conducted. Questionnaires were delivered in a sample of primary health care facilities as well as in the Governorate Public Hospital. Following literature review eight components were identified as contributors to job satisfaction; two closed questions for each of the eight components and two open questions were developed for a total of 18 questions.RESULTS: The final under-study population consisted of 285 individuals. Almost 40% of the participants at the study felt safe in its clinical environment while around 10% completely disagree on this. Almost 70% of participants reported agreement on high work load because of shortage of colleagues in the respective clinical area while almost 60% disagree on the fact they were not able to give proper care because of workload. Almost 85% of nurse under-study reported that salary did not cover their living cost and only 13% of them believed they earned a fair salary. Almost 60% agree on the fact that they have regular opportunities to develop in their career.CONCLUSION: Increasing job satisfaction among nurses in Egypt is critical to ensure quality of care for patients and aspect like salary, rewarding by coordinators and cooperation with colleagues deserve attention.

scholarly journals Report of the “satisfaction” survey amongst public health services nurses in Port Said

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Saverio Bellizzi ◽  
Susanna Padrini
Keyword(s):  
Public Health ◽  
Job Satisfaction ◽  
Health Services ◽  
Work Load ◽  
Health Care Facilities ◽  
Clinical Environment ◽  
Public Health Services ◽  
Cross Sectional ◽  
Port Said ◽  
High Work

Abstract Background There is a paucity of evidence regarding the job experience of nurses in Egypt. An unpublished previous pilot study conducted in the Port Said Technical Nursing Institute, which was based on 36 participants, showed that almost half of nurses were satisfied with their job; on the other hand, nurses indicated low salaries and high work-loads as main reasons for dissatisfaction. We explored job satisfaction of nurses working in public health services of the Port Said Governorate to inform future healthcare policy. Methods A cross-sectional study including nurses from different public health services was conducted. Questionnaires were delivered in a sample of primary health care facilities as well as in the Port Said Governorate public hospital. Following a literature review, eight components were identified as contributors to job satisfaction; two closed questions for each of the eight components and two open questions were devised for a total of 18 questions. Results The final study population consisted of 285 individuals. Almost 40.0% of the participants felt safe in their clinical environment while around 10.0% disagree on this. Almost 70.0% of participants complained about high work-load due to shortage of staff in the respective clinical area. Almost 85.0% of nurses reported that their salary did not cover living cost while only 13.0% indicated earning a fair salary. Almost 60.0% agreed with the fact that they have regular opportunities to develop in their career. Conclusion Increasing job satisfaction among nurses in Egypt is critical to ensure quality of care for patients. Issues such as salary, staffing and cooperation with colleagues deserve specific attention.

scholarly journals The impact of the COVID-19 response on the provision of other public health services in the U.S.: A cross sectional study

2021 ◽  
Author(s):  
Kristina W. Kintziger ◽  
Kahler W. Stone ◽  
Meredith Jagger ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Services ◽  
Cross Sectional Study ◽  
Health Departments ◽  
Public Health Services ◽  
Cross Sectional ◽  
Career Plans ◽  
Public Health Departments ◽  
Essential Public Health Services ◽  
The U.S

Abstract Background Funding and staff formerly dedicated to routine public health tasks (e.g., responding to communicable and non-communicable diseases, investigating foodborne outbreaks, conducting routine surveillance) and services (e.g., environmental health, substance abuse, maternal-child health) may no longer be available in many public health departments due to the COVID-19 response. The objective of this study was to assess the extent to which staffing for essential public health services has been redirected to the COVID-19 response. Methods This is a cross-sectional study using a survey distributed through the Qualtrics platform. Individuals (N = 298) working in public health across governmental and academic public health departments in the U.S. during the ongoing COVID-19 pandemic response were surveyed. Survey items measured multiple domains including professional experience (i.e., training, years of experience, content expertise, job functions), mental and physical health status (i.e., generalized anxiety, depression, burnout), and career plans (i.e., pre-pandemic vs. current career plans). Results The total number of content expertise areas and programmatic functions covered by individual public health workers increased between January and September of 2020, with 26% (73 of 282) of respondents reporting an increase in both. The total number of respondents working in infectious disease and preparedness remained constant, while declines were reported in program evaluation (-36%) and health education (-27%) and increases were reported in disease investigation (+ 35%). Conclusions The provision of many essential public health functions and tasks have been limited or eliminated while the U.S. public health workforce responds to the COVID-19 pandemic. These findings highlight opportunities for funding and professional development of public health systems, both during and after the COVID-19 response, to help ensure the continuity of essential public health services, staffing sustainability, and preparedness for future public health emergencies in the U.S. Trial registration: Not applicable.

scholarly journals Rural Resident Experience on National Basic Public Health Services: A Cross-Sectional Survey in 10 Western Provinces of China

Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 160
Author(s):  
Jinlin Liu ◽  
Ying Mao
Keyword(s):  
Public Health ◽  
Health Services ◽  
Large Scale ◽  
Health Management ◽  
Rural Resident ◽  
Public Health Services ◽  
Cross Sectional Survey ◽  
Rural Residents ◽  
Cross Sectional ◽  
Health Related

National basic public health services (BPHSs) are important for promoting the health of rural populations. A better understanding of rural BPHSs from the viewpoint of residents utilizing the services can help health-related departments and primary health care (PHC) centers further improve rural BPHSs. By conducting a large-scale cross-sectional survey in 10 western provinces of China, the study depicts rural resident experiences with rural BPHSs. Of the 9019 participants, 59.33% and 66.48% did not receive services related to health examinations or health education in the six months prior to the survey, respectively. A total of 56.90% were satisfied with the rural BPHSs, and the mean overall satisfaction score was 3.61 ± 0.908 (out of a maximum of 5). The most satisfying domain for rural residents with BPHSs was the attitude of PHC workers, whereas rural residents with chronic diseases were the least satisfied with the health management. Satisfaction with the attitude of PHC workers was identified as the strongest determinant of rural residents’ overall satisfaction with BPHSs. This study could enlighten rural BPHSs management in China.

scholarly journals Moderating effect of people-oriented public health services on depression among people under mandatory social isolation during the COVID-19 pandemic: a cross-sectional study in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bolin Cao ◽  
Dongya Wang ◽  
Yifan Wang ◽  
Brian J. Hall ◽  
Nan Wu ◽  
...  
Keyword(s):  
Public Health ◽  
Depressive Symptoms ◽  
Health Services ◽  
Social Isolation ◽  
Media Coverage ◽  
Perceived Risk ◽  
Perceived Quality ◽  
Public Health Services ◽  
Cross Sectional

Abstract Background Public health measures, such as social isolation, are vital to control the spread of the coronavirus disease 2019 (COVID-19), but such measures may increase the risk of depression. Thus, this study examines the influencing and moderating factors of depressive symptoms among individuals subjected to mandatory social isolation. Methods An online cross-sectional survey was conducted to collect data from people under mandatory home or centralized social isolation in Shenzhen, China, from February 28 to March 6, 2020. The perceived risk of infection with COVID-19, perceived tone of media coverage, perceived quality of people-oriented public health services, and their depressive symptoms were assessed. Three rounds of stepwise multiple regression were performed to examine the moderating effects after controlling various variables, such as demographics, duration and venue of mandatory social isolation, infection and isolation status of family, time spent on COVID-related news, and online social support. Results Among the 340 participants, 57.6% were men, the average age was 35.5 years old (SD = 8.37), and 55.6% held a bachelor’s degree or above. Individuals subjected to mandatory social isolation generally reported low levels of depressive symptoms. Perceived susceptibility to infection was relatively low, whereas perceived tone of media coverage was mainly positive. In terms of perceived quality of public health services, 12 (3.5%), 103 (30.3%), and 225 (66.2%) participants reported low, medium, and high quality of people-oriented services, respectively. Perceived susceptibility was positively associated with depression, whereas perceived tone of media coverage was negatively associated. The quality of people-centered public health services moderated the association between perceived risk and depressive symptoms and between perceived tone of media coverage and depressive symptoms. Conclusions This study revealed the depressive symptoms among individuals subjected to mandatory social isolation during the COVID-19 pandemic and highlighted that frontline public health workers play a critical role in protecting public mental health.

scholarly journals Impact of social capital, sex and education on the utilization of public health services: a cross sectional study based on the China migrant dynamic survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhen Yang ◽  
Cheng-hua Jiang
Keyword(s):  
Public Health ◽  
Social Capital ◽  
Health Education ◽  
Health Services ◽  
Public Health Services ◽  
Cross Sectional ◽  
Internal Migrants ◽  
Cognitive Social Capital ◽  
The Impact ◽  
Structural Social Capital

Abstract Background China is making efforts to promote the equalization of National Essential Public Health Services (NEPHS) for internal migrants. Studies have demonstrated that the impacts of social capital on health services are different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of NEPHS for the internal migrants and provide reference for other countries. Methods Data from the China Migrant Dynamic Survey of 2017, involving 130,642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of NEPHS. Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such impacts are moderated by sex and education. Results (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different sexs and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by sex. However, a high education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclusion Social capital plays an important role in the access of migrants to NEPHS. Governments should vigorously promote the construction of regional social capital, encourage migrants to actively participate in community activities, especially pay attention to the enhancement of the migrants with low SES to the destination identity.

scholarly journals Use of Health Services and Family Health Strategy Households Population Coverage in Brazil

2021 ◽  
Vol 26 (9) ◽  
pp. 3955-3964
Author(s):  
Otávio Pereira D’Avila ◽  
Luiz Alexandre Chisini ◽  
Francine dos Santos Costa ◽  
Mariana Gonzales Cademartori ◽  
Lucas Brum Cleff ◽  
...  
Keyword(s):  
Public Health ◽  
Health Services ◽  
Skin Color ◽  
Health Care Services ◽  
Family Health ◽  
Public Health Services ◽  
Cross Sectional ◽  
Health Strategy ◽  
Family Health Strategy ◽  
Use Of Health Services

Abstract The objective of this study is to describe the profile of use of primary health care services, estimated by the PNS, of the population living in households registered and not registered with the Famly Health Strategy - FHS, in the years 2013 and 2019. Cross-sectional study carried out using microdata from national health surveys 2013 and 2019. The sample originated from a master sample, consisting of a set of units from selected areas in a register..The variables sex, age, skin color, income, education, self-perceived health, home registered with the FHS, medical care in the last year, type of service you seek when you are ill were selected. The dependent variables were use of health services and use of public health services. The dependent and independent variables were described with the respective confidence interval and adjusted logistic regression was performed for each outcome analyzed. In public health services, lower income, have chronic diseases (arterial hypertension or high cholesterol), be pregnant, and having a bad self-perception of health were associated with used more health services in both periods. Living in registered households was associated with more used health services (public or private). The family health strategy is an important strategy for expanding access equally.

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