ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1555684
The combined effect of perception of pay fairness and institutional transparency on physicians' work enthusiasm: A mixed method study from China
Provisionally accepted
- 1Beijing University of Chinese Medicine, Beijing, China
- 2Ningxia Hui Autonomous Region People's Hospital, Yinchuan, Ningxia Hui Region, China
- 3Linyi People's Hospital, Linyi, Shandong Province, China
- 4Beijing Chest Hospital, Capital Medical University, Beijing, Beijing Municipality, China
- 5China-Japan Friendship Hospital, Beijing, Beijing Municipality, China
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Physician salary structures in Chinese public hospitals are crucial for motivating healthcare providers. Based on Expectancy Theory, this study aims to provide an evidence-based foundation for hospital managers in salary system design through investigating the combined effect of perceptions of pay fairness and institutional transparency on Chinese physicians' work enthusiasm, with a focus on the moderating effect of institutional transparency. A qualitative study was conducted from December 2023 to February 2024 to initially explore the relationships of perception of pay fairness, institutional transparency, and work enthusiasm. Subsequently, a quantitative study was conducted between April and May 2024 to examine the combined interaction of these factors. Physicians from Beijing, Haikou, Linyi, Nanjing, and Yinchuan were recruited to participate in the study. The qualitative analyses showed that most physicians knew the determinants of salary but were not familiar with the details. The monthly salary gaps acceptable by most physicians featured time allocation ranging from 0.5 to 1.0, or less than ¥10,000 ($1378). The structural results of the equation modeling showed that the perception of pay fairness had a significant and positive impact on work enthusiasm (β = 0.454, p < 0.001), and institutional transparency promoted the association between the perception of pay fairness and work enthusiasm (β = 0.229, p = 0.003). Therefore, reasonable salary gaps and awareness of the scheme are required to improve physicians' enthusiasm for their work.
Keywords: physician, Moderating role, Institutional transparency, Pay fairness, Work enthusiasm, Structural Equation Modeling, mixed study
Received: 16 Jan 2025; Accepted: 19 May 2025.
Copyright: © 2025 Hu, Ma, Wei, Jiang, Zhu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chunyu Zhang, China-Japan Friendship Hospital, Beijing, 100029, Beijing Municipality, China
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