Job Preferences of Caregivers in Integrated Medical and Nursing Care Facilities: A Discrete Choice Experiment

OBJECTIVES: This study investigates the occupational preferences of nursing staff within integrated medical and nursing care institutions in China.

METHODS: Discrete Choice Experiment (DCE) was adopted. Based on the literature and Delphi methods, we identified six attributes: monthly income, work pressure, income incentives, skills training, career development prospects, and work flexibility. We optimized the DCE through D-factorial design and implemented the experiment in multiple integrated medical and nursing care facilities in Hubei province. Statistical analyses were performed using conditional logit models.

RESULTS: A total of 552 responses regarding caregivers' job preferences were collected, with 538 questionnaires deemed valid. Among the six attributes studied, income level was most influential for nursing staff (β=0.581, p<0.001, 95% CI: 0.551-0.611). Additionally, preferences favored working hours below 40 hours per week, with no night shifts (β=0.485, p<0.001, 95% CI: 0.355-0.615, reference level: working hours exceeding 50 hours and more than two-night shifts). There are established guidelines for career progression or promotion ((β=0.290, p<0.001, 95% CI: 0.210-0.370, reference level: unclear avenues for career advancement or promotion). Nursing staff are willing to pay $117.08 per month to change their jobs from working more than 50 hours per week with more than two-night shifts to working less than 40 hours per week with no night shifts. In addition, nursing staff are willing to pay $70.01 per month to improve their jobs from having vague career advancement or promotion paths to having clear career advancement or promotion rules.

CONCLUSIONS: Increasing the income of nursing staff, implementing clear income incentive policies, and reducing work pressure are beneficial for retaining caregivers.