Improving Chinese primary care providers' recruitment and retention: a discrete choice experiment

Health Policy Plan. 2015 Feb;30(1):68-77. doi: 10.1093/heapol/czt098. Epub 2013 Dec 18.


Introduction: Local primary care facilities in China struggle to recruit and retain doctors and nurses. Implementing policies to address this issue requires detailed knowledge of the preferences of primary care workers. The aim of this study is to find out which job attributes affect Chinese primary care providers' choice of job and whether there are any differences in these job preferences between doctors and nurses.

Methods: A discrete choice experiment was used to analyse the job preferences of 517 primary care providers, including 282 doctors and 235 nurses.

Results: Chinese primary care providers in Community Health Organizations (CHOs) considered monetary factors and non-monetary factors when choosing a job. Doctors' and nurses' preferences over job attributes were similar. Though income was important, Chinese primary care providers had strongest preferences for sufficient welfare benefits, sufficient essential equipment and respect from the community. Younger primary care providers were more likely to value training and career development opportunities.

Conclusion: In order to retain skilled primary care providers to work in CHOs, policymakers in China need to improve primary care providers' income, benefits and working conditions to fulfil their basic needs. Policymakers also need to invest in CHOs' infrastructure and strengthen training programmes for primary care providers in order to raise the community's confidence in the services provided by CHOs.

Keywords: Job preferences; discrete choice experiments; primary care providers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • China
  • Female
  • Humans
  • Income / statistics & numerical data
  • Job Satisfaction
  • Male
  • Personnel Selection / organization & administration*
  • Personnel Turnover* / statistics & numerical data
  • Physicians, Primary Care / organization & administration*
  • Physicians, Primary Care / statistics & numerical data
  • Primary Care Nursing* / statistics & numerical data
  • Primary Health Care / organization & administration
  • Workforce