title: Why were doctors unable to accomplish their rural-aid mission in China? A qualitative study.
abstract: BACKGROUND
  To alleviate the difficulties of rural residents in receiving timely healthcare, the Chinese government launched a medical rural-aid program that solicited urban medical professionals to go to rural hospitals for a 1-year tenure. However, many of urban doctors did not accomplish this task. In this study, we attempted to investigate the reasons behind the failure to fulfill this program and to explore a more feasible solution.
  
  
  METHODS
  Eleven doctors and nurses participated in the focus group discussions. Twenty-five interviewees, including health administrative officials, doctors and managers from both urban tertiary hospitals and county-level hospitals, participated in semi-structured in-depth telephone interviews. The interview data were summarized and analyzed using the grounded theory.
  
  
  RESULTS
  The failure of this program was attributed to multiple causes, such as problems with the recipient hospitals, the support hospitals and the participating doctors, and overall defects in the program strategy itself. One major reason is the competition between the recipient hospitals and the support hospitals, which distorted the original purpose of this rural-aid program.
  
  
  CONCLUSIONS
  The rural-aid program strategy should be adjusted. The recipient hospitals should be township-level health centers rather than county-level hospitals. In addition, the relevant policies should be amended and improved accordingly. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Development and Planning, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan, China.
authors.forename: Hongxing
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Development and Planning, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Luo
authors.affiliation: School of Medicine and Health Management, Huazhong University of Science and Technology, Tongji Medical College, Wuhan, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of Medical Affair, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Qian
authors.affiliation: Department of Dermatology, People's Hospital of Zhengzhou, Zhengzhou, China.
authors.forename: Tianwei
authors.initials: T
authors.lastname: Shi
authors.affiliation: Global Health Institute, School of Public Health, Wuhan University, Wuhan, China.
authors.forename: Youmei
authors.initials: Y
authors.lastname: Feng
mesh_terms: D002681:China; D017144:Focus Groups; D006780:Hospitals, Rural / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D015397:Program Evaluation; D036301:Qualitative Research; D019035:Rural Health Services / Q000458:organization & administration; D012424:Rural Population; D000078329:Workforce
keywords: health policy; healthcare delivery; healthcare professionals; healthcare systems; the rural-aid health program