Academic Journal
Perceived red tape and occupational commitment among primary care physicians: a mixed-methods study of the mediating role of public service motivation.
| Τίτλος: | Perceived red tape and occupational commitment among primary care physicians: a mixed-methods study of the mediating role of public service motivation. |
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| Συγγραφείς: | Chang H; School of Public Administration, Shandong Normal University, Jinan, China. |
| Πηγή: | Frontiers in public health [Front Public Health] 2026 Jul 08; Vol. 14, pp. 1855480. Date of Electronic Publication: 2026 Jul 08 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Frontiers Editorial Office Country of Publication: Switzerland NLM ID: 101616579 Publication Model: eCollection Cited Medium: Internet ISSN: 2296-2565 (Electronic) Linking ISSN: 22962565 NLM ISO Abbreviation: Front Public Health Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Lausanne : Frontiers Editorial Office |
| Ιατρικοί όροι (MeSH): | Physicians, Primary Care*/psychology , Motivation* , Personnel Loyalty* , Job Satisfaction*, Humans ; China ; Male ; Female ; Adult ; Primary Health Care |
| Περίληψη: | Introduction: Occupational commitment among primary care physicians (PCPs) is critical for sustaining primary healthcare workforce stability, yet its institutional determinants remain insufficiently understood. This study examined whether perceived red tape is associated with occupational commitment and whether public service motivation (PSM) mediates this relationship. Methods: A convergent parallel mixed-methods design was employed. Quantitative data were collected from 306 PCPs across 36 primary healthcare facilities in Shandong Province, China. Confirmatory factor analysis and structural equation modeling were used to test the mediation model, with bias-corrected bootstrap confidence intervals and supplementary robustness checks. Qualitative data were obtained from semi-structured interviews with 36 PCPs and analyzed using thematic analysis. Results: Perceived red tape was negatively associated with PSM (b = -0.131, p = 0.013; β = -0.177), while PSM was positively associated with occupational commitment (b = 0.313, p < 0.001; β = 0.541). The indirect effect through PSM was statistically significant (b = -0.041, p = 0.047, 95% CI [-0.095, -0.010]), whereas the residual direct effect was not statistically significant after PSM was included. Qualitative analysis identified three forms of red tape: misaligned clinical regulations, repetitive documentation requirements, and administrative arrangements detached from clinical practice. These burdens were described as constraining autonomy, competence, and relatedness, which may help explain the motivational pathway. Conclusion: Perceived red tape was associated with lower occupational commitment among PCPs, with PSM serving as an important motivational pathway. Policy reforms should reduce low-value administrative burdens while preserving necessary regulatory functions. (Copyright © 2026 Chang.) |
| Competing Interests: | The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. |
| Contributed Indexing: | Keywords: mixed methods; occupational commitment; primary care physicians; public service motivation; red tape |
| Entry Date(s): | Date Created: 20260723 Date Completed: 20260723 Latest Revision: 20260723 |
| Update Code: | 20260723 |
| PubMed Central ID: | PMC13388552 |
| DOI: | 10.3389/fpubh.2026.1855480 |
| PMID: | 42487808 |
| Βάση Δεδομένων: | MEDLINE |
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