Strengthening workforce resilience to sustain community health services during crises: evidence from Chinese general practitioners
BackgroundEnsuring the resilience and retention of the primary healthcare workforce is critical to maintaining health service continuity during public health crises. While pandemic preparedness frameworks increasingly emphasize integrated economic and health policies, the role of organizational and...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1633175/full |
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| author | Botang Guo Botang Guo Yongbin Li Ying Fu Minyao Li Yue Wang Shuyu Liu Yanjuan Zhou Yu Liu Ping Tang |
| author_facet | Botang Guo Botang Guo Yongbin Li Ying Fu Minyao Li Yue Wang Shuyu Liu Yanjuan Zhou Yu Liu Ping Tang |
| author_sort | Botang Guo |
| collection | DOAJ |
| description | BackgroundEnsuring the resilience and retention of the primary healthcare workforce is critical to maintaining health service continuity during public health crises. While pandemic preparedness frameworks increasingly emphasize integrated economic and health policies, the role of organizational and psychological factors in sustaining frontline health personnel has received less empirical attention. This study aimed to investigate the prevalence of turnover intention among community general practitioners (GPs) in Luohu District, Shenzhen, China, and to examine the mediating role of work engagement in the relationship between perceived organizational resilience and turnover intention.MethodsA cross-sectional survey was conducted among 927 community health physicians from Aug to Dec in 2024 in Luohu District, Shenzhen, a region where all community health centers are governed by a unified hospital group. Participants completed validated scales assessing organizational resilience, work engagement, and turnover intention. Descriptive statistics, correlation analysis, and hierarchical regression analysis were performed. The mediating effect of work engagement was tested using bootstrapping procedures, controlling for significant demographic and occupational covariates.ResultsA high prevalence of turnover intention was observed, with 65.16% of GPs reporting high or very high levels. Significant differences in turnover intention were found across age groups, professional titles, cadre status, monthly income, and perceived public health workload. Mediation analysis revealed that work engagement partially mediated the relationship between organizational resilience and turnover intention (B = −0.018, 95%CI [−0.070,–0.011] without covariates; adjusted indirect effect B = –0.019, 95%CI [−0.026,–0.012] with covariates), accounting for approximately 16.82% (17.12% adjusted) of the total effect. These relationships remained significant after controlling for covariates.ConclusionTurnover intention among community GPs in the studied region is alarmingly high, posing a significant challenge to workforce stability. Organizational and psychological resources play a key role in mitigating workforce attrition risks in community health systems. Strengthening organizational resilience and fostering work engagement may offer cost-effective, non-technological strategies to maintain essential health service delivery capacity during future pandemics, aligning with broader goals of economic stability and pandemic preparedness. |
| format | Article |
| id | doaj-art-40e431a84252454db898caba260e71f5 |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-40e431a84252454db898caba260e71f52025-08-20T03:50:58ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.16331751633175Strengthening workforce resilience to sustain community health services during crises: evidence from Chinese general practitionersBotang Guo0Botang Guo1Yongbin Li2Ying Fu3Minyao Li4Yue Wang5Shuyu Liu6Yanjuan Zhou7Yu Liu8Ping Tang9Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, ChinaDepartment of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Physical Examination, Rehabilitation Branch of Luohu District Traditional Chinese Medicine Hospital, Shenzhen, ChinaDepartment of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, ChinaDepartment of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, ChinaSchool of Medicine, Harbin Vocational and Technical University, Harbin, ChinaCenter of Psychological, Harbin First Specialized Hospital, Harbin, ChinaCollege of Marxism, Harbin Medical University, Harbin, ChinaDepartment of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, ChinaDepartment of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, ChinaBackgroundEnsuring the resilience and retention of the primary healthcare workforce is critical to maintaining health service continuity during public health crises. While pandemic preparedness frameworks increasingly emphasize integrated economic and health policies, the role of organizational and psychological factors in sustaining frontline health personnel has received less empirical attention. This study aimed to investigate the prevalence of turnover intention among community general practitioners (GPs) in Luohu District, Shenzhen, China, and to examine the mediating role of work engagement in the relationship between perceived organizational resilience and turnover intention.MethodsA cross-sectional survey was conducted among 927 community health physicians from Aug to Dec in 2024 in Luohu District, Shenzhen, a region where all community health centers are governed by a unified hospital group. Participants completed validated scales assessing organizational resilience, work engagement, and turnover intention. Descriptive statistics, correlation analysis, and hierarchical regression analysis were performed. The mediating effect of work engagement was tested using bootstrapping procedures, controlling for significant demographic and occupational covariates.ResultsA high prevalence of turnover intention was observed, with 65.16% of GPs reporting high or very high levels. Significant differences in turnover intention were found across age groups, professional titles, cadre status, monthly income, and perceived public health workload. Mediation analysis revealed that work engagement partially mediated the relationship between organizational resilience and turnover intention (B = −0.018, 95%CI [−0.070,–0.011] without covariates; adjusted indirect effect B = –0.019, 95%CI [−0.026,–0.012] with covariates), accounting for approximately 16.82% (17.12% adjusted) of the total effect. These relationships remained significant after controlling for covariates.ConclusionTurnover intention among community GPs in the studied region is alarmingly high, posing a significant challenge to workforce stability. Organizational and psychological resources play a key role in mitigating workforce attrition risks in community health systems. Strengthening organizational resilience and fostering work engagement may offer cost-effective, non-technological strategies to maintain essential health service delivery capacity during future pandemics, aligning with broader goals of economic stability and pandemic preparedness.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1633175/fullorganizational resiliencework engagementturnover intentioncommunity health servicespandemic preparedness |
| spellingShingle | Botang Guo Botang Guo Yongbin Li Ying Fu Minyao Li Yue Wang Shuyu Liu Yanjuan Zhou Yu Liu Ping Tang Strengthening workforce resilience to sustain community health services during crises: evidence from Chinese general practitioners Frontiers in Public Health organizational resilience work engagement turnover intention community health services pandemic preparedness |
| title | Strengthening workforce resilience to sustain community health services during crises: evidence from Chinese general practitioners |
| title_full | Strengthening workforce resilience to sustain community health services during crises: evidence from Chinese general practitioners |
| title_fullStr | Strengthening workforce resilience to sustain community health services during crises: evidence from Chinese general practitioners |
| title_full_unstemmed | Strengthening workforce resilience to sustain community health services during crises: evidence from Chinese general practitioners |
| title_short | Strengthening workforce resilience to sustain community health services during crises: evidence from Chinese general practitioners |
| title_sort | strengthening workforce resilience to sustain community health services during crises evidence from chinese general practitioners |
| topic | organizational resilience work engagement turnover intention community health services pandemic preparedness |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1633175/full |
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