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Performance-based payments and intrinsic motivation among primary healthcare workers in China: a cross-sectional survey

Health

Objective The study aimed to examine whether pay-for-performance (performance-based payment (PBP)) may crowd out intrinsic motivation by analysing the association between the proportions of the PBP component of the total salary and intrinsic motivation levels among primary healthcare workers in China. Design A cross-sectional survey. The primary outcome was intrinsic motivation, measured using the intrinsic motivation subscale of the 15-item work motivation scale. Setting and participants The study involved 1927 primary healthcare workers from 31 institutions in Weifang city, Shandong province, China. Interventions The proportion of PBP was the primary intervention variable. Additionally, subanalysis was conducted across different performance dimensions, including whom to incentivise and the domain of performance measured.

BMJ     Jun 26, 2025