Turnover intention (TI) among doctors is a critical issue in healthcare systems worldwide, as it can lead to workforce shortages, increased workload for remaining staff, and negatively impact patient care. This review aimed to explore the prevalence and determinants of TI among doctors, providing a comprehensive understanding of the factors influencing their turnover intentions. A systematic review was conducted using four electronic databases: PubMed, Web of Science, Medline, and Scopus. Studies published between January 2019 and December 2024 were included. Observational studies reporting the prevalence of turnover intention among doctors and meeting the inclusion criteria were selected for analysis. Two independent reviewers assessed the eligibility of each study, and relevant data were extracted and recorded. A random-effects meta-analysis was performed to evaluate the prevalence of turnover intention, with heterogeneity assessed using the I². Subgroup analysis and meta-regression were conducted to examine variations in study-level characteristics. A total of 34 studies (involving 97,672 doctors) were included in this review. The overall prevalence of turnover intention among doctors was 39% (95% CI = 0.34–0.44). Those doctors with lower job satisfaction (OR = 0.484, 95% CI = 0.358–0.654) were more likely to express an intention to leave their current positions. However, the odds ratio for male doctors (OR = 1.251, 95% CI = 0.916–1.708) did not reach statistical significance. Approximately 39% of doctors reported turnover intention. Lower job satisfaction was identified as a significant risk factor for turnover intention among doctors, whereas male gender was not found to be a statistically significant predictor.

Aim: This study aimed to evaluate the operational efficiency of traditional Chinese medicine (TCM) hospitals in China.Methods: Pearson’s analysis was used to test the correlation between the input and output variables. Data envelopment analysis (DEA) was utilized to analyze the input and output variables of 16 TCM hospitals, and each hospital efficiency score was computed by Deap 2.1, assuming variable return to scale (VRS), which is an input-oriented model. t tests were conducted to confirm the significant difference of efficiency scores at the hospital level and by hospital type, and ANOVA was used to test for significant differences in efficiency scores according to hospitals’ size.Results: The correlation coefficient of the input and output indicators was between 0.613 and 0.956 (p < 0.05). The difference in number of doctors (ND) and numbers of pharmacists (NP) were statistically significant (p < 0.05) at the hospital level. The mean efficiency scores for technical efficiency (TE), pure technical efficiency (PTE), and scale efficiency (SE) in secondary TCM hospitals were 0.766, 0.919, and 0.838, respectively. Additionally, the lowest TE, PTE, and SE were 0.380, 0.426, and 0.380, respectively. Eight TCM hospitals in this study were DEA efficient, with an efficiency score of 1. There were no statistically significant differences in TE, PTE, and SE among hospital levels, hospital types or hospital sizes groups (p > 0.05).Conclusion: This study revealed that tertiary TCM hospitals had a greater level of efficiency than secondary TCM hospitals. In our study, 50% of TCM hospitals had inefficient management. Therefore, to activate the new development power of TCM hospitals, it is necessary to reform and improve the management system and mechanism of TCM hospitals, optimize the development environment of TCM hospitals and formulate development plans and measures based on local conditions.

Purpose: To explore the influencing factors of medical dissatisfaction experiences from the perspectives of patients, and provide corresponding strategies for its prevention. Patients and Methods: Using multistage random sampling, 43 hospitals in three provinces of China were surveyed using a self-designed questionnaire. There were 2065 valid questionnaires analyzed in our study. Results: 46.9% (n = 934) of participants had experienced medical dissatisfaction in the past year, mainly due to poor service quality, cumbersome procedures and high medical costs. There were statistically significant differences in the medical dissatisfaction experiences for these patients with different ages, marital status and levels of education (P< 0.05). According to structural equation modelling, health education and media reports had a positive and indirect influence (standardized coefficient = 0.046) on medical dissatisfaction experiences, while there was a negative correlation (standardized coefficient = − 0.399) between patients’ social recognition and medical dissatisfaction experiences. Also, our results also found that social relationships had a negative and indirect impact (standardized coefficient = − 0.166) on medical dissatisfaction experiences. Besides, health education and media reports had a negative impact (standardized coefficient = − 0.115) on patients’ social recognition, while social relationships have a positive effect (standardized coefficient = 0.416) on patients’ social recognition. Conclusion: Health education and media reports and social relationships, as antecedent variables, have an indirect effect on inducing the medical dissatisfaction experiences of patients. In addition, patients’ social recognition was an intermediate variable in inducing the medical dissatisfaction of patients.

Purpose: This review mainly aims to identify the lean practice conducted in hospitals, determining what problems lean practice can be helpful to solve in the hospitals. Data sources: Four electronic databases (Scopus, Web of science, Medline, and PubMed) were conducted for searching related literature in this review. Study selection: These studies in the hospitals that related lean healthcare practice and contained outcome variables were included. Data extraction: Related information such as research design, countries, lean tools, outcome variables, results were extracted. Results of data synthesis: 20 eligible articles were identified in this review. There was 20% lean practice being conducted in emergency department of hospitals in this review. Six cases have implemented lean in Brazilian hospitals. There were 12 cases implemented lean practice through Value Stream Mapping. Conclusion: Lean practices were highly valued in Brazilian hospitals, and it was frequently implemented in hospital emergency department. Value Stream Mapping and process mapping were the most commonly used lean tool. Waiting time, lead time and Length of Hospital Stay (LOS) were the primary indicators reflecting improvements in this review.

Background: Doctor turnover is a significant challenge faced by hospitals worldwide, particularly in public hospitals in China. By understanding how job attributes influence job preferences among doctors, effective and targeted policies can be designed to attract doctors to key positions or organizations, providing insights for evidence-based workforce interventions.Objectives: The aim of our study is to examine the difference of job preferences of doctors in different hospitals levels using DCE.Methods: A discrete choice experiment was applied in the public hospital in China. A total of 920 eligible doctors from primary, secondary, and tertiary public hospital in China participated in this study. A mixed logit model was applied to assess job preferences among doctors in public hospital in China.Results: Doctors in primary hospitals preferred job offers with 30% salary increase over the unchanged (OR = 8.906, p < 0.001). Similar trends were observed in secondary and tertiary hospitals (OR = 4.785, p < 0.001; OR = 5.56, p < 0.001). Doctors from all hospital levels (primary, secondary, and tertiary) preferred sufficient opportunities of professional development (OR = 1.43, p = 0.032; OR = 1.47, p = 0.008; OR = 1.44, p < 0.001). A 20% increase in workload was generally less favored in all hospital levels (OR = 0.63, p = 0.015; OR = 0.45, p < 0.001; OR = 0.42, p < 0.001). Environmental support was only preferred in tertiary hospitals (OR = 1.46, p < 0.001). Monthly salary was the top priority for doctors across all hospital levels, followed by work atmosphere. Employee care came third in primary and secondary hospitals, while opportunities of professional development ranked the third in tertiary hospitals. Environmental support from hospital was the least prioritized factor in both secondary hospitals, while workload was the least important in primary and tertiary hospitals.Conclusion: Doctors preferred job offers with salary increases across all hospital levels. Professional development opportunities were prioritized universally, while 20% increase in workload was generally least favored. Environmental support was most important in tertiary hospitals. Monthly salary and work atmosphere were top priorities across all hospital levels, with employee care ranking third in primary and secondary hospitals. Workload and environmental support were the least prioritized, varying by hospital level.