Date Published: January 25, 2019
Publisher: Public Library of Science
Author(s): Shimeng Liu, Shunping Li, Yujia Li, Haipeng Wang, Jingjing Zhao, Gang Chen, Sakamuri V. Reddy.
There is a deficiency of healthcare administrators in China as compared with other countries; furthermore, the distribution is unequal. To inform an effective policy intervention, it is crucial to understand healthcare administration students’ career decision-making. This study aims to investigate the undergraduate students’ stated preferences when choosing a job.
A discrete choice experiment (DCE) was conducted among a population-based multistage sample of 668 final year undergraduate healthcare administration students during April to June 2017 in eight universities of China to elicit their job preferences. Attributes include location, monthly income, bianzhi (which refers to the established posts and can be loosely regarded as state administrative staffing), training and career development opportunity, working environment and workload. Conditional and mixed logit models were used to analyze the relative importance of job attributes.
All six attributes were statistically significant with the expected sign and demonstrated the existence of preference heterogeneity. Monthly income, workload and working environment were of most concern to healthcare administration students when deciding their future. Among the presented attributes bianzhi was of the least concern. Sub-group analysis showed that students who have an urban background and/or with higher annual family incomes were willing to pay more for working in the city. In addition, students from western and middle universities valued bianzhi higher than students from eastern universities.
This is the first study focusing on the career decision-making of Chinese healthcare administration students at a critical career decision-making point. Both monetary and non-monetary interventions could be considered by policy-makers to attract students to work in health institutions, especially in rural and remote health institutions in China. There exists preference heterogeneity on healthcare administration students’ job preferences, which should also be taken into account in developing more effective policy incentive packages.
Effective health reforms will necessarily deal with the three major resource inputs of any national health system: financial, physical and human resources . Undoubtedly, it is more difficult to allocate the limited human resources due to the dynamically changing nature of this resource . Achieving equity in health is an important aspect of social fairness, whereas one of the biggest challenges is to achieve equity in health workforce distribution [3–6]. Although the World Health Organization has recommended several policy interventions, such as recruiting students with a rural background and embedding a rural course so that students would become more familiar with remote conditions and more likely to return to rural areas after graduation , the unevenly distributed health workforce remains a significant issue in both developed and developing countries. In China, human resources for health were considered as the least mapped and analyzed . The distribution of health professionals is largely determined by the market instead of the government because health professionals have the right to practice wherever they choose based on their own preferences and the availability of positions .
To the best of our knowledge, this is the first study using DCE methodology to investigate job preferences of healthcare administration students internationally. All six attributes considered in our study were found to be statistically significant in influencing student preferences to choose a job.
In conclusion, for healthcare administration students in China, the preferred scenario was to select a better working environment job with light workload located in the city, which can offer 8000 CNY monthly, sufficient training and career development opportunities and with bianzhi. Both monetary and non-monetary attributes were found to be significantly influential in affecting students’ preferences for choosing a job. In addition, there exists a certain degree of both observable and unobservable preference heterogeneity among students, which should also be taken into account in developing more effective policy incentive packages.