Effects of performance appraisal among health workers in township health centers:a heterogeneity analysis

Objective To examine effects of four performance appraisal (PA) patterns (linkage of PA to individual's income,feedback of PA to individuals,publicity of PA,and linkage of PA results to career promotion)on job satisfaction and work performance among township health workers with different personal characteristics.Methods Multi-stage sampling process was applied in study population selection and a cross-sectional questionnaire survey was conducted among 805 health workers in 45 township health centers in Shandong,Anhui,and Shanxi province.Multi-level logistic regression was used to examine the variation in PA effects among different groups of health workers.Results Of the 770 participants with eligible response,77.5% reported the linkage of PA to their income;58.7% reported the feedback of PA to individuals;and 72.2% reported the dissatisfaction to PA policy.In terms of the proportion of the participants with self-reported high job performance,the highest ratio (68.9%) was for task performance,followed by the ratio for learning performance (60.5%) and the lowest ratio (53.6%) was for contextual performance.The medical technicians were more satisfied to PA than the nurses at the public announcement of PA results (β=1.48);the task performance was higher among prevention and health care workers than among the nurses when receiving the feedback of PA (β=1.02);the health workers aged over 35 years had a lower contextual performance compared to those younger than 35 when the PA was linked to career promotion (β=-0.62).Conclusion The effects of PA are different among township health workers with various characteristics.Better outcomes could be resulted from the PA with public announcement among medical technicians and that with feedback to individuals among prevention and health care workers and a higher task performance could be achieved by the implementation of PA with linkage to career promotion among young health workers.