To learn the size and income of off-staff medical workers in a survey of public county-level general hospitals in China.

Human resources investigation of public county-level general hospitals, with SPSS data analysis of the outcomes.

From 2011 to 2013, the proportion of off-staff medical workers increased from 31.44% to 36.69%, of whom the highest proportion was found in China's western region, accounting for 40.69%; the ratio of off-staff practicing physicians increased from 14.24% to 16.64%, of whom China's central region accounted for 19.92%; the ratio of off-staff nurses increased from 43.03% to 49.77%, of whom China's western region accounted for 55.88%. In 13.7% of the hospitals, income of off-staff medical workers was less than a half of that for permanent staff; 41.32% and 26.31% of the hospitals surveyed were fully covered with social insurance and housing fund account respectively.

Off-staff labor is a distinct feature at such hospitals, making imperative a HR system reform of public hospitals.The discriminative income and welfare between permanent and off-staff medical workers calls for a fundamental change to the income and welfare system.

County-level general hospitals; Medical workers; HR management; Welfare; Off-staff