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How China’s new health reform influences village doctors’ income structure: evidence from a qualitative study in six counties in China

Overview of attention for article published in Human Resources for Health, May 2015
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (68th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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5 tweeters
facebook
1 Facebook page

Citations

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17 Dimensions

Readers on

mendeley
49 Mendeley
Title
How China’s new health reform influences village doctors’ income structure: evidence from a qualitative study in six counties in China
Published in
Human Resources for Health, May 2015
DOI 10.1186/s12960-015-0019-1
Pubmed ID
Authors

Shengfa Zhang, Weijun Zhang, Huixuan Zhou, Huiwen Xu, Zhiyong Qu, Mengqi Guo, Fugang Wang, You Zhong, Linni Gu, Xiaoyun Liang, Zhihong Sa, Xiaohua Wang, Donghua Tian

Abstract

In 2009, health-care reform was launched to achieve universal health coverage in China. A good understanding of how China's health reforms are influencing village doctors' income structure will assist authorities to adjust related polices and ensure that village doctors employment conditions enable them to remain motivated and productive. This study aimed to investigate the village doctors' income structure and analyse how these health policies influenced it. Based on a review of the previous literature and qualitative study, village doctors' income structure was depicted and analysed. A qualitative study was conducted in six counties of six provinces in China from August 2013 to January 2014. Forty-nine village doctors participated in in-depth interviews designed to document their income structure and its influencing factors. The themes and subthemes of key factors influencing village doctors' income structure were analysed and determined by a thematic analysis approach and group discussion. Several policies launched during China's 2009 health-care reform had major impact on village doctors. The National Essential Medicines System cancelled drug mark-ups, removing their primary source of income. The government implemented a series of measures to compensate, including paying them to implement public health activities and provide services covered by social health insurance, but these have also changed the village doctors' role. Moreover, integrated management of village doctors' activities by township-level staff has reduced their independence, and different counties' economic status and health reform processes have also led to inconsistencies in village doctors' payment. These changes have dramatically reduced village doctors' income and employment satisfaction. The health-care reform policies have had lasting impacts on village doctors' income structure since the policies' implementation in 2009. The village doctors have to rely on the salaries and subsidies from the government after the drug mark-up was cancelled. China's national health reforms are attempting to draw village doctors into the national health workforce, but the policies have impacted their income and independence. Further research into these concerns and monitoring of measures to adequately compensate village doctors should be undertaken. Reasonable compensation strategies should be established, and sufficient subsidies should be allocated in a timely manner.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 49 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Portugal 1 2%
United Kingdom 1 2%
Unknown 47 96%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 10 20%
Researcher 9 18%
Student > Master 9 18%
Other 5 10%
Student > Bachelor 4 8%
Other 12 24%
Readers by discipline Count As %
Medicine and Dentistry 12 24%
Social Sciences 10 20%
Nursing and Health Professions 6 12%
Psychology 4 8%
Unspecified 4 8%
Other 13 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 May 2015.
All research outputs
#1,153,968
of 5,064,898 outputs
Outputs from Human Resources for Health
#208
of 395 outputs
Outputs of similar age
#48,769
of 157,331 outputs
Outputs of similar age from Human Resources for Health
#20
of 36 outputs
Altmetric has tracked 5,064,898 research outputs across all sources so far. Compared to these this one has done well and is in the 76th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 395 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.3. This one is in the 46th percentile – i.e., 46% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 157,331 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 36 others from the same source and published within six weeks on either side of this one. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.