Certification, intention to stay, and monthly income among long-term care workers in China: a cross-sectional survey

Developing the long-term care (LTC) workforce requires evidence on workers’ career plans and earnings, as well as their qualifications. We examined associations of qualifications and certification plans with intention to stay in LTC work and monthly income. Methods We analyzed a survey conducted from June to September 2024 through Fushoukang’s service and training network. Of 7,264 respondents, 7,156 met the analysis criteria. Logistic regression examined intention to stay, and ordinary least-squares regression examined the natural logarithm of monthly income estimated from reported brackets. Both models used standard errors clustered across 60 cities. Results Among respondents, 59.4% reported at least 9 daily working hours including travel, 31.9% reported no monthly rest days, and 86.7% reported an intention to stay. Workers with qualifications had higher odds of intention to stay than those without qualifications (OR 1.63, 95% CI 1.29 to 2.06). Active certification plans were also associated with higher odds (OR 2.93, 95% CI 2.40 to 3.59). Estimated income differences were 2.93% (95% CI −5.91 to 12.61%) for having a qualification and −0.46% (95% CI −4.06 to 3.27%) for active plans. Conclusion Holding a qualification and having an active certification plan were associated with higher odds of intention to stay. Income comparisons varied across qualification groups, with no clear difference between workers with a qualification and those without one.