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Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention

BACKGROUND: Village doctors (VDs) in China undertook arduous primary healthcare missions. However, they received little attention in comparison to doctors in urban public secondary and tertiary hospitals. There is an urgent need to explore the overall situation of turnover intention and job burnout...

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Autores principales: Chen, Yuquan, You, Yanwei, Shen, Yaying, Du, Zifei, Dai, Tao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9684668/
https://www.ncbi.nlm.nih.gov/pubmed/36438210
http://dx.doi.org/10.3389/fpubh.2022.970780
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author Chen, Yuquan
You, Yanwei
Shen, Yaying
Du, Zifei
Dai, Tao
author_facet Chen, Yuquan
You, Yanwei
Shen, Yaying
Du, Zifei
Dai, Tao
author_sort Chen, Yuquan
collection PubMed
description BACKGROUND: Village doctors (VDs) in China undertook arduous primary healthcare missions. However, they received little attention in comparison to doctors in urban public secondary and tertiary hospitals. There is an urgent need to explore the overall situation of turnover intention and job burnout among VDs to evaluate and adjust current health manpower policy. METHODS: In this study, seven databases like PubMed, EMBASE, Web of Science (WOS), WanFang, China Science and Technology Journal Database (VIP), Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) were systematically searched, relevant experts were consulted, and empirical research on job burnout and turnover intention among VDs in international publications was evaluated. Therefore, we evaluated the prevalence of job burnout among VDs in general, across all dimensions and different severity levels, as well as the scores of each category. For turnover intention, we assessed the prevalence of different groups and their overall situation and also identified significant contributors. RESULTS: In this study, we integrated 20 research evidences on job burnout and turnover intention among 23,284 VDs from almost all provinces in China, and the prevalence of turnover intention among VDs in China was as high as 44.1% [95% confidence interval (CI): 34.1–54.2], which was two to four times that of primary health workers in high-income countries, but not much different from some developing countries. Simultaneously, VDs with the highest risk of turnover intention were men [odds ratio (OR): 1.22 (1.05–1.43)], those with a monthly income below USD 163.4 [OR: 0.88 (0.78–0.98)], those with a high educational level [OR: 0.88 (0.78–0.98)], and those <40 years old [OR: 1.27 (1.16–1.40)]. Similarly, the detection rate of job burnout toward them was 59.8% (95% CI: 38.7–79.1) with the MBI-GS score being 44.44 (95% CI: 37.02–51.86) in a total of 90, while the detection rate of job burnout in moderate and above almost reached 20%. The most significant contributor that affects job burnout was low personal accomplishment (LPA), and the detection rate for moderate and higher severity was 65.2% (95% CI: 58.7–71.7). CONCLUSION: Attention should be paid to the high turnover intention and severe job burnout of primary health workers in rural areas of developing countries, and targeted measures should be taken to improve the situation. Health policymakers should increase financial subsidies for VDs, set a reasonable workload, improve various health policies such as pension insurance for VDs, and encourage “targeted training” for medical students to enrich and expand their team. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021289139.
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spelling pubmed-96846682022-11-25 Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention Chen, Yuquan You, Yanwei Shen, Yaying Du, Zifei Dai, Tao Front Public Health Public Health BACKGROUND: Village doctors (VDs) in China undertook arduous primary healthcare missions. However, they received little attention in comparison to doctors in urban public secondary and tertiary hospitals. There is an urgent need to explore the overall situation of turnover intention and job burnout among VDs to evaluate and adjust current health manpower policy. METHODS: In this study, seven databases like PubMed, EMBASE, Web of Science (WOS), WanFang, China Science and Technology Journal Database (VIP), Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) were systematically searched, relevant experts were consulted, and empirical research on job burnout and turnover intention among VDs in international publications was evaluated. Therefore, we evaluated the prevalence of job burnout among VDs in general, across all dimensions and different severity levels, as well as the scores of each category. For turnover intention, we assessed the prevalence of different groups and their overall situation and also identified significant contributors. RESULTS: In this study, we integrated 20 research evidences on job burnout and turnover intention among 23,284 VDs from almost all provinces in China, and the prevalence of turnover intention among VDs in China was as high as 44.1% [95% confidence interval (CI): 34.1–54.2], which was two to four times that of primary health workers in high-income countries, but not much different from some developing countries. Simultaneously, VDs with the highest risk of turnover intention were men [odds ratio (OR): 1.22 (1.05–1.43)], those with a monthly income below USD 163.4 [OR: 0.88 (0.78–0.98)], those with a high educational level [OR: 0.88 (0.78–0.98)], and those <40 years old [OR: 1.27 (1.16–1.40)]. Similarly, the detection rate of job burnout toward them was 59.8% (95% CI: 38.7–79.1) with the MBI-GS score being 44.44 (95% CI: 37.02–51.86) in a total of 90, while the detection rate of job burnout in moderate and above almost reached 20%. The most significant contributor that affects job burnout was low personal accomplishment (LPA), and the detection rate for moderate and higher severity was 65.2% (95% CI: 58.7–71.7). CONCLUSION: Attention should be paid to the high turnover intention and severe job burnout of primary health workers in rural areas of developing countries, and targeted measures should be taken to improve the situation. Health policymakers should increase financial subsidies for VDs, set a reasonable workload, improve various health policies such as pension insurance for VDs, and encourage “targeted training” for medical students to enrich and expand their team. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021289139. Frontiers Media S.A. 2022-11-10 /pmc/articles/PMC9684668/ /pubmed/36438210 http://dx.doi.org/10.3389/fpubh.2022.970780 Text en Copyright © 2022 Chen, You, Shen, Du and Dai. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Chen, Yuquan
You, Yanwei
Shen, Yaying
Du, Zifei
Dai, Tao
Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention
title Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention
title_full Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention
title_fullStr Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention
title_full_unstemmed Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention
title_short Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention
title_sort village doctors' dilemma in china: a systematic evaluation of job burnout and turnover intention
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9684668/
https://www.ncbi.nlm.nih.gov/pubmed/36438210
http://dx.doi.org/10.3389/fpubh.2022.970780
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