Program Structure and Organizational Support as Correlates of Retention and Satisfaction in a Student-Dominated Hospital Volunteer Cohort: A Cross- Sectional Study

Background: In Chinese tertiary hospitals, volunteer programmes are an integral part of patient-facing operations. We examined organisational and task-related factors associated with volunteers’ intention to continue among active hospital volunteers in a Chinese tertiary teaching hospital. Methods: We conducted a cross-sectional survey of registered hospital volunteers and examined factors associated with (i) definite intention to continue volunteering and (ii) maximum overall satisfaction using prespecified binary logistic regression models (top-box outcomes). Results: In binary logistic regression models targeting high-threshold outcomes, a perceived high level of program structure (measured by a single-item global rating) emerged as the strongest predictor of both definite retention intention (OR 4.19) and maximum satisfaction (OR 6.01). Perceived Organisational Support (POS) scale scores (Q22; 3-item and 2-item forms) showed directionally consistent associations in sensitivity analyses (Supplementary Table S3). Conclusions: In this active cohort, a highly structured and comprehensive organisational support system (single-item rating) and related programme features were strongly associated with definite continuation intention and very high satisfaction; POS scale scores corroborated the direction of these associations in sensitivity analyses. These findings provide an empirical foundation for hospital administrators to re-engineer support frameworks and foster sustained engagement among active student-volunteer workforces. These findings suggest that hospital volunteer management in this context should transition from a transactional focus on logging service hours to a 'structured support' model. This involves formalizing feedback channels and clarifying role boundaries, which our data suggest are key drivers of the psychological contract for student volunteers.