Chinese primary care providers and motivating factors on performance

Background: China launched its new health care reform in 2009. One of its goals is to improve primary care system and strengthen primary care workforce. Although it has been studied internationally, motivating factors for primary care workforce have not been examined in China. Aim: To provide an overview of major performance motivating factors for primary care providers (PCPs) in China and examine associations between these factors and individual and practice setting characteristics. Methods: Data for the study were from the 2011 China Primary Care Workforce Survey that provides the most current assessment of community-based PCPs. Outcome measures were scores indicating performance improvement due to 11 factors. Covariates representing personal and practice characteristics included age, gender, education, location, types of providers and specialties. Outcomes were compared by PCP category and urban/rural setting. Associations were assessed using logistic regressions. Results: The most important motivating factors for PCPs to improve performance were professional development, training opportunities, living environment, benefits, working conditions and income. There were greater needs for improvement in rural than urban settings, especially in living environment. Types of PCPs were associated with needs for improvement in different factors. There were more needs from nurses and village doctors. Conclusions: A new and comprehensive incentive mechanism could be designed and implemented in China, which (i) focuses on more professional development opportunities, enhanced training programs and better compensation and benefits and (ii) targets PCPs practicing in different settings.