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It's all about the money? A qualitative study of healthcare worker motivation in urban China

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Millar, Ross, Chen, Yaru, Wang, Meng, Fang, Liang, Liu, Jun, Xuan, Zhidong and Li, Guohong (2017) It's all about the money? A qualitative study of healthcare worker motivation in urban China. International Journal for Equity in Health, 16 (1). 120. doi:10.1186/s12939-017-0616-9

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Official URL: https://doi.org/10.1186/s12939-017-0616-9

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Abstract

Background:
China’s healthcare reform programme continues to receive much attention. Central to these discussions has been how the various financial incentives underpinning reform efforts are negatively impacting on the healthcare workforce. Research continues to document these trends, however, qualitative analysis of how these incentives impact on the motivation of healthcare workers remains underdeveloped. Furthermore, the application of motivational theories to make sense of healthcare worker experiences has yet to be undertaken.

Methods:
The purpose of our paper is to present a comparative case study account of healthcare worker motivation across urban China. It draws on semi structured interviews (n = 89) with a range of staff and organisations across three provinces. In doing so, the paper analyses how healthcare worker motivation is influenced by a variety of financial incentives; how motivation is influenced by the opportunities for career development; and how motivation is influenced by the day to day pressures of meeting patient expectations.

Results:
The experience of healthcare workers in China highlights how a reliance on financial incentives has challenged their ability to maintain the values and ethos of public service. Our findings suggest greater attention needs to be paid to the motivating factors of improved income and career development. Further work is also needed to nurture and develop the motivation of healthcare workers through the building of trust between fellow workers, patients, and the public.

Conclusions:
Through the analysis of healthcare worker motivation, our paper presents a number of ways China can improve its current healthcare reform efforts. It draws on the experience of other countries in calling for policy makers to support alternative approaches to healthcare reform that build on multiple channels of motivation to support healthcare workers.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Social Sciences > Warwick Business School > Entrepreneurship, Innovation & Management
Faculty of Social Sciences > Warwick Business School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Health care reform -- China., Medical policy -- China., Medical personnel -- Employment -- China, Medical economics -- China, Employee retention -- China., Hospitals -- Personnel management., Health insurance -- China.
Journal or Publication Title: International Journal for Equity in Health
Publisher: BioMed Central Ltd.
ISSN: 1475-9276
Official Date: 7 July 2017
Dates:
DateEvent
7 July 2017Published
28 June 2017Accepted
Volume: 16
Number: 1
Article Number: 120
DOI: 10.1186/s12939-017-0616-9
Status: Peer Reviewed
Publication Status: Published
Publisher Statement: ** From PubMed via Jisc Publications Router. ** History: ** received: 10-02-2017 ** accepted: 28-06-2017
Access rights to Published version: Open Access
Funder: Guo jia zi ran ke xue ji jin wei yuan hui (China) [National Natural Science Foundation of China] (NSFC)
Grant number: 71173147

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