Incentive affects physicians’ willingness to continue participating in urban–rural medical consortia: a comparative study of county and provincial hospitals in Central China

The World Health Organization asserts that incentives significantly impact physicians’ participation in healthcare initiatives. China introduced incentive programs to boost involvement in urban–rural medical consortia. However, research is limited on: (a) the effectiveness of these incentives on physicians’ willingness to continue participating, (b) disparities in incentive levels between county and provincial hospitals, and (c) the varying impact of incentives on physicians’ continued participation in county versus provincial hospitals. This study aims to address these issues and suggest appropriate strategies.

An online survey in Henan Province, Central China, was conducted among 1,837 physicians, comprising 1,088 respondents from county hospitals and 749 respondents from provincial hospitals. Participants reported their demographic characteristics, altruism, collaborative projects, incentive levels and willingness to continue participating. Chi-square and multinomial logistic regressions were used to determine the incentive factors of participants’ willingness.

(a) For all participants, the level of economic returns, position and professional title promotion, skills improvement were positively associated with willingness to continue participating in urban–rural medical consortia. (b) County-level hospitals had lower level of various incentives for urban–rural medical consortium projects than provincial hospitals. (c) County-level physicians who had a high level of position and title promotion, professional skills improvement and provincial physicians who had a high level of economic returns and rewards had a high level of willingness to continue participating in urban–rural medical consortia.

This study demonstrates that the current financial incentives in provincial hospitals and non-financial incentives in county hospitals are efficacious in enhancing physicians’ willingness to continue participating. This information can assist policymakers in hospitals at different levels in developing or improving incentive mechanisms.