ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1555819
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 45 articles
Did the reform of the public hospitals' pay system increase the physicians' pay in China? A cross-sectional study
Provisionally accepted
- 1College of Humanities and Social Development, Northwest A&F University, xianyang, China
- 2School of Public Policy and Administration, Xi'an Jiaotong University, Xi’an, Shaanxi, China
- 3School of Public Health, Xi’an Jiaotong University, Xi'an, Shaanxi, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: In 2017, the government initiated a pilot program for the public hospitals' pay system (RPHPS) aimed at enhancing physician compensation. We investigated the extent to which the reform impacted the physicians' pay and analyzed the factors that determine their pay.Methods: This cross-sectional study utilized China Public Hospitals' Compensation Reform Survey from 2017, which included a sample of 178,622 physicians. Total annual pay and annual performance-based pay were considered as the primary outcomes, while basic pay, allowance and other forms of pay were classified as the secondary outcomes. We employed coarsened exact matching and hierarchical linear analysis to investigate the relationship between the RPHPS and pay, as well as the factors influencing pay.Results: The total annual pay and annual performance-based pay of physicians in the exposure group were significantly higher by 6.3% (coef: 0.06; p < 0.01) and 19.2% (coef: 0.19; p < 0.001), respectively, compared to the control group. We did not find a significant relationship between RPHPS and basic pay or allowances.Physicians' pay was associated with gender, age, educational status, professional titles, years of working and departments. Male physicians received 4% higher total annual salary and 6% higher performance-based pay than their female counterparts.Conclusions: Positive relationships were observed between the RPHPS and both the total annual pay and performance-based pay of physicians. Significant gender disparities were identified in total annual pay, performance-based pay and allowances. The government should promote the RPHPS to enhance physicians' pay and implement initiatives aimed at achieving equal pay for equal work, irrespective of gender.
Keywords: the reform of the public hospitals' pay system, Physicians, total annual pay, performance-based pay, Allowance
Received: 05 Jan 2025; Accepted: 12 May 2025.
Copyright: © 2025 Zhao, Zhou, Zhai, Guanping, Wang and Deng. 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: Zhongliang Zhou, School of Public Policy and Administration, Xi'an Jiaotong University, Xi’an, 710049, Shaanxi, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.