title: Satisfaction of village doctors with the township and village health services integration policy in the western minority-inhabited areas of China.
abstract: Township and Village Health Services Integration Management (TVHSIM) is an essential form of China's two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China's new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors' satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors' personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels (all P<0.05). Age (P<0.05) and years of practice (P<0.01) were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level (P<0.05) was negatively correlated with Operations Management as well. However, social insurance status (P<0.05) was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors' satisfaction with TVHSIM (P<0.01). In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Da
authors.initials: D
authors.lastname: Feng
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. zhangliang@mails.tjmu.edu.cn.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Hubei University of Chinese Medicine, Wuhan, 430030, China.
authors.forename: Yuan-Xi
authors.initials: YX
authors.lastname: Xiang
authors.affiliation: Department of Health Policy and Management, College of Public Health, University of Georgia, Georgia, GA, USA.
authors.forename: Dong-Lan
authors.initials: DL
authors.lastname: Zhang
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Ruo-Xi
authors.initials: RX
authors.lastname: Wang
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Shang-Feng
authors.initials: SF
authors.lastname: Tang
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Fu
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Bo-Yang
authors.initials: BY
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D010820:Physicians / Q000523:psychology*; D012423:Rural Health / Q000592:standards*; D019035:Rural Health Services / Q000592:standards*; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: minority-inhabited areas; satisfaction; township and village health services integration management; village doctors; western China