Objectives: Using the person-environment (PE) fit theory, this study aims to explore factors affecting medical professionals’ job satisfaction, turnover intention, and professional efficacy, and to examine individual characters associated with PE fit. Design and methods: This study used data from the sixth National Health Service Survey conducted in 2018, with a focus on job outcomes among medical professionals in Shanghai. The reliability and validity of the tools for measuring PE and job outcomes were calculated. A structural equation model was used to examine the relationship among person-job (PJ) fit and person-group (PG) fit, job satisfaction, turnover intention, and professional efficacy. Finally, a hierarchical regression model was used to analyze the association between demographic variables and the PJ and PG fit. Results: PG fit was directly and positively associated with job satisfaction and professional efficacy. PJ fit had a direct and positive association with job satisfaction but had a direct and negative association with turnover intention. The indirect association of PJ fit with turnover intention was statistically significant. The results from the hierarchical regression analysis showed that younger physicians generally had a lower level of PJ fit and older physicians with higher education tended to have a lower level of PG fit. Conclusions: Medical professionals with higher PJ or PG fit have higher job satisfaction, and those with higher PG fit have higher professional efficacy. The impact of PJ fit on turnover intention was mediated by job satisfaction. Healthcare managers should take actions to effectively promote medical professionals’ PJ and PG fit to improve their retention and efficiency.

Objectives Person-organisation fit (P-O fit) is a predictor of work attitude. However, in the area of human resource for health, the literature of P-O fit is quite limited. It is unclear whether P-O fit directly or indirectly affects turnover intention. This study aims to examine the mediation effect of job satisfaction on the relationship between P-O fit and turnover intention based on data from China. Design and methods This is a cross-sectional survey of community health workers (CHWs) in China in 2013. A questionnaire of P-O fit, job satisfaction and turnover intention was developed, and its validity and reliability were assessed. Multiple regression and structural equation modelling were used to examine the relationship among P-O fit, job satisfaction and turnover intention. Setting and participants Multistage sampling was applied. In total, 656 valid questionnaire responses were collected from CHWs in four provincial regions in China, namely Shanghai, Shaanxi, Shandong and Anhui. Results P-O fit was directly related to job satisfaction (standardised β 0.246) and inversely related to turnover intention (standardised β −0.186). In the mediation model, the total effect of P-O fit on turnover intention was −0.186 (p<0.001); the direct effect of P-O fit on turnover intention was −0.094 (p<0.01); the indirect effect of job satisfaction on the relationship between P-O fit and turnover intention was −0.092 (p<0.001). Conclusions The effect of P-O fit on turnover intention was partially mediated through job satisfaction. It is suggested that more work attitude variables and different dimensions of P-O fit be taken into account to examine the complete mechanism of person-organisation interaction. Indirect measures of P-O fit should be encouraged in practice to enhance work attitudes of health workers.

Objectives: The study analysed medical malpractice claims to assess patient safety in hospitals. The information derived from malpractice claims reflects potential risks and could help lead to reducing medical errors and improving patient safety. Design, setting: We analysed 4380 medical malpractice claims from 351 grade-A tertiary hospitals in China for 2008–2017. We examined the characteristics of medical errors and patient safety, including the types of medical errors, proportionate liabilities and payments for medical malpractice in different clinical specialties. Main outcome measures: We assessed claim characteristics, payment amounts and liability. Results: Our data analysis demonstrated that 72.5% of the claims involved medical errors, with average payments of US$31 430. The hospital’s errors in medical malpractice resulted in 41.4% average liability in patient injury payments. Most medical malpractice cases occurred in Shanghai (817 claims, 18.7%) and Beijing (468 claims, 10.7%). The highest risks for medical error and malpractice claims were related to orthopaedics (11.3% of all claims, 72.8% with medical errors) and obstetrics and gynaecology (10.0% of all claims, 76.0% with medical errors). The highest rates related to proportionate liabilities were observed in otolaryngology (51.9%) and endocrinology (47.7%). Respiratory medicine had the highest proportion of claims in death rates (77.3%). Medical technology errors accounted for 91.8% of the claims and medical ethics errors for 5.8%. The highest average payment was found in cardiovascular surgery (US$41 733) and the lowest in stomatology (US$8822). Conclusions: A previous study found that grade-A tertiary hospitals in China have similar medical error rates to general Chinese hospitals. ³⁶ Different specialties had different risk characteristics regarding medical errors, payments and proportionate liabilities. Orthopaedics had the highest number of malpractices claims and higher proportionate liability but lower death rates.

Background: The global COVID-19 pandemic has been widely regarded as a catalyst for adopting internet health care technology (IHT) in China. IHT consists of new health care technologies that are shaping health services and medical consultations. Health care professionals play a substantial role in the adoption of any IHT, but the consequences of doing so can often be challenging, particularly when employee burnout is prevalent. Few studies have explored whether employee burnout influences the adoption intention of IHT in health care professionals. Objective: This study aims to explain the determinants influencing the adoption of IHT from the perspective of health care professionals. To do so, the study extends the value-based adoption model (VAM) with consideration for employee burnout as a determining factor. Methods: A cross-sectional web-based survey using a sample of 12,031 health care professionals selected through multistage cluster sampling from 3 provinces in mainland China was conducted. The hypotheses of our research model were developed based on the VAM and employee burnout theory. Structural equation modeling was then used to test the research hypotheses. Results: The results indicate that perceived usefulness, perceived enjoyment, and perceived complexity positively correlate with perceived value (β=.131, P=.01; β=.638, P<.001; β=.198, P<.001, respectively). Perceived value had a positive direct effect on adoption intention (β=.725, P<.001), perceived risk negatively correlated with perceived value (β=−.083, P<.001), and perceived value negatively correlated with employee burnout (β=−.308, P<.001). In addition, employee burnout was negatively related to adoption intention (β=−.170, P<.001) and mediated the relationship between perceived value and adoption intention (β=.052, P<.001). Conclusions: Perceived value, perceived enjoyment, and employee burnout were the most important determinants of IHT adoption intention by health care professionals. In addition, while employee burnout was negatively related to adoption intention, perceived value inhibited employee burnout. Therefore, this study finds that it is necessary to develop strategies to improve the perceived value and reduce employee burnout, which will benefit the promotion of the adoption intention of IHT in health care professionals. This study supports the use of the VAM and employee burnout in explaining health care professionals’ adoption intention regarding IHT.

Background: The promotion of a healthy diet via health education is a component of the “Healthy China 2030” plan. However, few studies have reported whether health knowledge about nutrition and diet has gained public attention, and whether it is needed by the public.Methods: The numbers of views, shares, and reads of articles published by the official WeChat account of a hospital in China were accessed. The influence index was obtained via the entropy analysis of these three indices. A questionnaire survey was developed based on the purpose of the study and the conclusion of the content analysis, which conducted to analyze users' requirements for health knowledge and their influencing factors. Moreover, risk factors were explored by logistic regression models.Results: Of the 103 articles considered in this study, four articles in the Top 10 were related to nutrition and diet. The influence index of nutrition and diet knowledge was found to be the highest in the content analysis (p < 0.05). The higher degrees of humor (β = 0.224, p = 0.027), nutrition and diet articles (β = 0.776, p = 0.034), and cover articles (β = 0.312, p = 0.021) have significant influences on the influence index. In total, 581 questionnaires were obtained, and 78.1% of the respondents reported believing that the health knowledge of greatest concern was that related to nutrition and diet. Multivariate logistic regression analyses were conducted to explore the associations between the features of the articles and users reading nutrition and diet knowledge; it was found that gender (female, OR: 4.651, 95%Cl: 2.598, 8.325, and p < 0.001), age (young adult, OR: 0.358, 95%Cl: 0.266, 0.481, and p < 0.001), cancer precaution knowledge (OR: 4.333, 95%Cl: 2.262, 8.299, and p < 0.001), traditional Chinese medicine (OR: 2.121, 95%Cl: 1.064, 4.230, and p = 0.033), the knowledge acquisition approach [circle of friends (OR: 2.586, 95%Cl: 1.373, 4.868, and p = 0.003), social media (OR: 2.183, 95%Cl: 1.204, 3.960, and p = 0.010)), hospitals (OR: 3.194, 95%Cl: 1.793, 5.692, and p < 0.001), television media (OR: 4.348, 95%Cl: 2.341, 8.077, and p < 0.001)], and social media strategies [professionalism and authority (OR: 2.354, 95%Cl: 1.231, 4.505, and p = 0.006)] have statistically significant relationships with users reading nutrition and diet knowledge.Conclusion: Nutrition and diet knowledge could contribute to WeChat user engagement of health information dissemination. Nutrition professionals should improve the scientific popularization ability and effectively use social media for health promotion.

Health reform in China since 2009 has emphasized basic public health services to enhance the function of Community Health Services as a primary health care facility. A variety of studies have documented these efforts, and the challenges these have faced, yet up to now the experience of primary health care (PHC) providers in terms of how they have coped with these changes remains underdeveloped. Despite the abundant literature on psychological coping processes and mechanisms, the application of coping research within the context of human resources for health remains yet to be explored. This research aims to understand how PHC providers coped with the new primary health care model and the job characteristics brought about by these changes. Semi-structured interviews with primary health care workers were conducted in Jinan city of Shandong province in China. A maximum variation sampling method selected 30 PHC providers from different specialties. Thematic analysis was used drawing on a synthesis of theories related to the Job Demands-Resources model, work adjustment, and the model of exit, voice, loyalty and neglect to understand PHC providers’ coping strategies. Our interviews identified that the new model of primary health care significantly affected the nature of primary health work and triggered a range of PHC providers’ coping processes. The results found that health workers perceived their job as less intensive than hospital medical work but often more trivial, characterized by heavy workload, blurred job description, unsatisfactory income, and a lack of professional development. However, close relationship with community and low work pressure were satisfactory. PHC providers’ processing of job demands and resources displayed two ways of interaction: aggravation and alleviation. Processing of job demands and resources led to three coping strategies: exit, passive loyalty, and compromise with new roles and functions. Primary health care providers employed coping strategies of exit, passive loyalty, and compromise to deal with changes in primary health work. In light of these findings, our paper concludes that it is necessary for the policymakers to provide further job resources for CHS, and involve health workers in policy-making. The introduction of particular professional training opportunities to support job role orientation for PHC providers is advocated.