This result is consistent with Hypothesis 1 and, to some extent, it also confirms Atella and Deb [3], who find a substitutive individual health care utilization between contract and non-contract physicians using Italian data.
Given the extensive utilization of contracts in supply chains, the issues concerning contract analysis and design are extremely important for supply chain management (SCM), and substantial research has been developed to address those issues over the past years.
Table 5 displays the results of logistic regression models estimating the effects of hospital utilization of contract-based nurses and each type of job dissatisfaction among contract-based nurses on two types of patient outcomes respectively.
The hospital-level utilization of contract-based nurses was estimated by dividing the number of surveyed contract-based nurses by the total number of surveyed nurses in each hospital.
Our results suggest a high utilization of contract-based nurses in Chinese hospitals, and that the inequities in benefits between contract-based nurses and 'bianzhi' nurses may adversely affect both nurse and patient satisfaction in hospitals.
The study employs survey data from a large geographically representative sample of hospitals in China to examine current rates of contract-based nurse utilization and determines the relationship between contract-based nurse employment, contract-based nurse dissatisfaction, contract-based nurse intentions to leave, and patient satisfaction in Chinese hospitals.
This variation may reflect a trend toward increasing utilization of contract-based nurses.
Hospital-level utilization of contract-based nurses varies greatly from 0 to 91%, with an average of 51%.
This study describes the very common utilization of contract-based nurses in Chinese hospitals and potential inequitable practices in salary and benefits among this category of nurses.
Previous papers report higher service utilization of contracted out PHC facilities due to improved functioning of these facilities and provision of adequate levels of staffing, medicines, supplies and equipment [ 7, 8, 23– 26].
