AUTHOR=Zhao Yaxin , Zhou Zhongliang , Zhai Xiaohui , Liu Guanping , Wang Zhichao , Deng Qiwei 

TITLE=Did the reform of the public hospitals' pay system increase the physicians' pay in China? A cross-sectional study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1555819

DOI=10.3389/fpubh.2025.1555819

ISSN=2296-2565

ABSTRACT=BackgroundIn 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.MethodsThis 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.ResultsThe 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.ConclusionPositive 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.