Preferences of Medical Sciences Students for Work Contracts in Deprived Areas of Iran: A Discrete Choice Experiment Analysis

Figures & data

Figure 1 Schematic picture of the health system network in Iran.

Table 1 The Importance of Work Contracts’ Attributes from the Perspective of Participants in a Likert Scale (1 the Highest and 5 the Lowest Importance)

Attributes	Importance	Female (%)	Male (%)	Total (%)	P-value
Wage	1	89 (65.44)	86 (59.31)	175 (62.27)	< 0.001
	2	35 (25.73)	50 (34.48)	85 (30.24)
	3	10 (7.35)	9 (6.20)	19 (6.76)
	4	0 (0)	0 (0)	0 (0.00)
	5	0 (0)	0 (0)	0 (0.00)
	missing	2 (1.47)	0 (0)	2 (0.07)
Place of medical center	1	77 (56.62)	59 (40.70)	136 (48.40)	< 0.001
	2	46 (33.82)	69 (47.58)	115 (40.92)
	3	8 (5.88)	13 (8.96)	21 (7.47)
	4	2 (1.47)	3 (2.09)	5 (1.78)
	5	0 (0)	0 (0)	0 (0.00)
	missing	3 (2.21)	1 (0.69)	4 (1.42)
Payment time	1	70 (51.47)	68 (46.89)	138 (49.11)	< 0.001
	2	48 (35.29)	60 (41.38)	108 (38.43)
	3	14 (10.29)	13 (8.96)	27 (9.61)
	4	1 (0.73)	4 (2.76)	6 (2.14)
	5	0 (0)	0 (0)	0 (0.00)
	missing	2 (1.47)	0 (0)	2 (0.71)
Housing and transportation facilities	1	63 (46.32)	43 (29.65)	106 (37)	< 0.001
	2	57 (41.91)	65 (44.83)	122 (43.41)
	3	14 (10.29)	34 (23.45)	48 (17.08)
	4	0 (0)	3 (2.07)	3 (1.07)
	5	0 (0)	0 (0)	0 (0)
	missing	2 (1.47)	0 (0)	2 (0.71)
Contract time	1	55 (40.44)	43 (29.65)	98 (34.87)	< 0.001
	2	65 (47.79)	66 (45.52)	131 (46.62)
	3	12 (8.82)	33 (22.76)	45 (16.01)
	4	1 (0.73)	2 (1.38)	3 (1.67)
	5	1 (0.73)	1 (0.68)	2 (0.71)
	missing	2 (1.47)	0 (0)	2 (0.71)
Scholarship	1	56 (41.18)	47 (32.41)	103 (36.65)	< 0.001
	2	45 (33.09)	51 (35.17)	96 (34.16)
	3	25 (18.38)	36 (24.83)	61 (21.71)
	4	4 (2.94)	8 (5.52)	12 (4.27)
	5	3 (2.21)	3 (2.07)	6 (2.14)
	missing	3 (2.21)	0 (0)	3 (1.07)
Workload	1	57 (41.91)	29 (20)	86 (30.60)	< 0.001
	2	51 (37.50)	74 (51.03)	125 (44.48)
	3	20 (14.71)	40 (27.58)	60 (21.35)
	4	5 (3.68)	2 (1.38)	7 (2.49)
	5	1 (0.73)	0 (0)	1 (0.36)
	missing	2 (1.47)	0 (0)	2 (0.71)
Total (%)		136(48.40)	145(51.60)	281 (100)

Figure 2 Opinion of medical group students about importance of work contracts’ attributes.

Table 2 The Results of Conditional Logit Model of the Effect of Choosing Work Contracts on the Students’ Utilities

Choice	Coef	[95% CI]	aOR	[95% CI]	P-value
Payment (base: capitation)
Capitation +30% bonus	0.323	(0.160, 0.485)	1.381	(1.174, 1.624)	<0.001
Capitation +50% bonus	0.761	(0.601, 0.921)	2.140	(1.823, 2.513)	<0.001
Place of medical center (base: own province)
A nearby province	−0.509	(−0.656, −0.361)	0.601	(0.518, 0.696)	<0.001
A faraway province	−0.926	(−1.087, −0.764)	0.396	(0.337, 0.465)	<0.001
Financial settlements (base: max to 15 days)
Between 15 to 30 days	−0.059	(−0.223, 0.105)	0.942	(0.799, 1.110)	0.479
Between 30 to 60 days	−0.137	(−0.304, 0.030)	0.872	(0.737, 1.031)	0.109
Housing and transportation facilities (base: no)
Yes	0.209	(0.066, 0.351)	1.232	(1.068, 1.420)	0.004
Duration of contract (base: one year)
3 years	−0.068	(−0.221, 0.086)	0.935	(0.801, 1.089)	0.389
5 years	−0.120	(−0.297, 0.058)	0.887	(0.742, 1.059)	0.187
Quotations for continuing education (base: no)
After 4 years’ work in deprived area(s)	0.220	(0.066, 0.374)	1.246	(1.068, 1.453)	0.005
After 8 years’ work in deprived area(s)	−0.025	(−0.189, 0.138)	0.975	(0.827, 1.149)	0.763
Workload (base: low)
Moderate	0.022	(−0.132, 0.176)	1.022	(0.876, 1.192)	0.780
Heavy	−0.221	(−0.369, −0.073)	0.802	(0.691, 0.928)	0.003
Observations	3934
Log likelihood	−1178
Pseudo R2	0.136
Prob > chi2	< 0.001

Abbreviations: Coef, coefficient; aOR, adjusted odds ratio; CI, confidence Interval.

Table 3 The Results of Conditional Logit Model of the Effect of Choosing Sub-Group Work Contracts on the Students’ Utilities

Choice	Sex				Place of Birth				Major						Education Period
	Female		Male		Urban		Rural		Medicine		Pharmacy		Dentistry		Without tuition		with Tuition
	aOR	p-value	aOR	p-value	aOR	p-value	aOR	p-value	aOR	p-value	aORaOR	p-value	aOR	p-value	aOR	p-value	aOR	p-value
Payment (base: capitation)
capitation +30% bonus	1.389	0.005	1.394	0.005	1.372	<0.001	1.566	0.254	1.387	0.004	1.597	0.012	1.334	0.095	1.348	0.002	1.457	0.024
capitation +50% bonus	2.11	<0.001	2.2	<0.001	2.121	<0.001	2.729	0.015	2.406	<0.001	2.602	<0.001	1.48	0.018	1.998	<0.001	2.643	<0.001
Place of medical center (base: own province)
A nearby province	0.659	<0.001	0.551	<0.001	0.597	<0.001	0.68	0.339	0.609	<0.001	0.748	0.076	0.474	<0.001	0.588	<0.001	0.644	0.006
A faraway province	0.417	<0.001	0.375	<0.001	0.392	<0.001	0.482	0.071	0.444	<0.001	0.276	<0.001	0.398	<0.001	0.389	<0.001	0.422	<0.001
Financial Settlements (base: max to 15 days)
Between 15 to 30 days	0.974	0.83	0.906	0.402	0.935	0.429	1.155	0.741	1.011	0.927	0.921	0.671	0.863	0.384	0.99	0.916	0.823	0.283
Between 30 to 60 days	0.83	0.123	0.914	0.463	0.874	0.123	0.868	0.744	0.925	0.509	0.925	0.695	0.737	0.077	0.831	0.058	1.038	0.833
Housing and transportation facilities (base: no)
Yes	1.199	0.079	1.26	0.026	1.218	0.008	1.603	0.19	1.215	0.054	1.275	0.148	1.29	0.083	1.243	0.009	1.219	0.197
Duration of contract (base: one year)
3 years	1.024	0.832	0.868	0.211	0.947	0.495	0.718	0.428	0.954	0.671	0.821	0.254	0.998	0.991	0.968	0.714	0.805	0.206
5 years	0.978	0.866	0.824	0.127	0.889	0.201	0.835	0.715	0.939	0.615	0.9	0.615	0.804	0.241	0.963	0.713	0.657	0.036
Quotations for continuing education (base: no)
After 4 years work in deprived area(s)	0.924	0.48	1.676	<0.001	1.243	0.007	1.323	0.473	1.279	0.021	1.482	0.029	1.043	0.799	1.132	0.166	1.721	0.001
After 8 years work in deprived area(s)	0.835	0.133	1.128	0.309	0.959	0.622	1.405	0.445	0.925	0.497	1.049	0.803	0.941	0.723	0.907	0.307	1.237	0.23
Workload (base: low)
Moderate	1.105	0.375	0.963	0.738	1.021	0.792	1.025	0.951	41.15	0.184	0.732	0.089	1.037	0.821	1.094	0.313	0.79	0.172
Heavy	0.755	0.009	0.859	0.155	0.797	0.003	0.899	0.771	0.978	0.832	0.558	0.001	0.704	0.022	0.85	0.06	0.656	0.008
Observations	1904		2030		3766		168		2058		966		910		2982		952
Log likelihood	-573		-595		-1127		-50		–621		–257		–276		–900		–272
Pseudo R2	0.132		0.154		0.137		0.146		0.130		0.233		0.126		0.129		0.176
Prob > chi2	< 0.001		< 0.001		< 0.001		0.1994		<0.001		<0.001		<0.001		<0.001		<0.001

Abbreviations: Coef, coefficient; aOR, adjusted odds ratio; CI, confidence Interval.