ArticleFrontiers in public health2026
Perceived red tape and occupational commitment among primary care physicians: a mixed-methods study of the mediating role of public service motivation.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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 ( 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.
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