Physician turnover in China, 2011–2021: a nationwide longitudinal study
Abstract Background There have been a globally paucity of comprehensive quantitative studies on the physician turnover trends. This study aimed to investigate the trajectory and magnitude of Chinese physician turnover, as well as its influencing factors. Methods We established a retrospective cohort...
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2025-08-01
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| Online Access: | https://doi.org/10.1186/s12960-025-01009-z |
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| author | Xiaoxu Wang Qiufen Sun Lijin Chen Yaoguang Zhang Yue Cai Ruixian Wu Shuai Wang Xiang Cui Jun Lv Shiyong Wu Liming Li |
| author_facet | Xiaoxu Wang Qiufen Sun Lijin Chen Yaoguang Zhang Yue Cai Ruixian Wu Shuai Wang Xiang Cui Jun Lv Shiyong Wu Liming Li |
| author_sort | Xiaoxu Wang |
| collection | DOAJ |
| description | Abstract Background There have been a globally paucity of comprehensive quantitative studies on the physician turnover trends. This study aimed to investigate the trajectory and magnitude of Chinese physician turnover, as well as its influencing factors. Methods We established a retrospective cohort by combining annual physician surveillance data and annual medical institution report data between 2011 and 2021. Turnover was defined as physicians who changed their practice institution at least once between 2011 and 2021. We reported the national annual turnover rate, net turnover rate of different regions and types of healthcare institutions. The direction of turnover across provinces and institutions was exhibited using Sankey diagrams. A time-dependent Cox regression analysis was used to examine the factors that influence physician turnover. Results This study included 3.7 million physicians, with 19.4% changing practice institutions between 2011 and 2021. The national annual turnover rate has risen from 1.6% to 4.4%. The majority of turnover occurred within provinces and the same type of healthcare institutions. Eastern regions and urban areas experienced net turnover inflow. Factors that increased the likelihood of physician turnover include: being younger, male, more educated, having senior professional titles, having non-permanent employment contracts, working in rural, non-hospital, or private institutions, and working in institutions with relatively low revenue or high workload. Conclusions This study suggests that the physician turnover rate is rising in China. Polices should pay more attention to physician retention in less-developed regions. The underlying causes of physician turnover should be thoroughly investigated. Continuous monitoring of physician turnover is critical to leverage its potential positive impact on revitalizing the healthcare system and to avoid its possible negative impact on equal geographic distribution of physicians. |
| format | Article |
| id | doaj-art-3054379f59f34ac78a7e0f82ac5d33bd |
| institution | Kabale University |
| issn | 1478-4491 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Human Resources for Health |
| spelling | doaj-art-3054379f59f34ac78a7e0f82ac5d33bd2025-08-20T03:43:22ZengBMCHuman Resources for Health1478-44912025-08-0123111210.1186/s12960-025-01009-zPhysician turnover in China, 2011–2021: a nationwide longitudinal studyXiaoxu Wang0Qiufen Sun1Lijin Chen2Yaoguang Zhang3Yue Cai4Ruixian Wu5Shuai Wang6Xiang Cui7Jun Lv8Shiyong Wu9Liming Li10Department of Epidemiology & Biostatistics, School of Public Health, Peking UniversityDepartment of Epidemiology & Biostatistics, School of Public Health, Peking UniversityCenter for Health Statistics and Information, National Health Commission of the PRCCenter for Health Statistics and Information, National Health Commission of the PRCCenter for Health Statistics and Information, National Health Commission of the PRCDepartment of Epidemiology & Biostatistics, School of Public Health, Peking UniversityCenter for Health Statistics and Information, National Health Commission of the PRCDepartment of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Epidemiology & Biostatistics, School of Public Health, Peking UniversityCenter for Health Statistics and Information, National Health Commission of the PRCDepartment of Epidemiology & Biostatistics, School of Public Health, Peking UniversityAbstract Background There have been a globally paucity of comprehensive quantitative studies on the physician turnover trends. This study aimed to investigate the trajectory and magnitude of Chinese physician turnover, as well as its influencing factors. Methods We established a retrospective cohort by combining annual physician surveillance data and annual medical institution report data between 2011 and 2021. Turnover was defined as physicians who changed their practice institution at least once between 2011 and 2021. We reported the national annual turnover rate, net turnover rate of different regions and types of healthcare institutions. The direction of turnover across provinces and institutions was exhibited using Sankey diagrams. A time-dependent Cox regression analysis was used to examine the factors that influence physician turnover. Results This study included 3.7 million physicians, with 19.4% changing practice institutions between 2011 and 2021. The national annual turnover rate has risen from 1.6% to 4.4%. The majority of turnover occurred within provinces and the same type of healthcare institutions. Eastern regions and urban areas experienced net turnover inflow. Factors that increased the likelihood of physician turnover include: being younger, male, more educated, having senior professional titles, having non-permanent employment contracts, working in rural, non-hospital, or private institutions, and working in institutions with relatively low revenue or high workload. Conclusions This study suggests that the physician turnover rate is rising in China. Polices should pay more attention to physician retention in less-developed regions. The underlying causes of physician turnover should be thoroughly investigated. Continuous monitoring of physician turnover is critical to leverage its potential positive impact on revitalizing the healthcare system and to avoid its possible negative impact on equal geographic distribution of physicians.https://doi.org/10.1186/s12960-025-01009-zPersonnel turnoverPhysiciansChinaInfluencing factors |
| spellingShingle | Xiaoxu Wang Qiufen Sun Lijin Chen Yaoguang Zhang Yue Cai Ruixian Wu Shuai Wang Xiang Cui Jun Lv Shiyong Wu Liming Li Physician turnover in China, 2011–2021: a nationwide longitudinal study Human Resources for Health Personnel turnover Physicians China Influencing factors |
| title | Physician turnover in China, 2011–2021: a nationwide longitudinal study |
| title_full | Physician turnover in China, 2011–2021: a nationwide longitudinal study |
| title_fullStr | Physician turnover in China, 2011–2021: a nationwide longitudinal study |
| title_full_unstemmed | Physician turnover in China, 2011–2021: a nationwide longitudinal study |
| title_short | Physician turnover in China, 2011–2021: a nationwide longitudinal study |
| title_sort | physician turnover in china 2011 2021 a nationwide longitudinal study |
| topic | Personnel turnover Physicians China Influencing factors |
| url | https://doi.org/10.1186/s12960-025-01009-z |
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