TY - JOUR
T1 - Determinants of rural Australian primary health care worker retention
T2 - A synthesis of key evidence and implications for policymaking
AU - Russell, Deborah J.
AU - McGrail, Matthew R.
AU - Humphreys, John S.
N1 - Funding Information:
The authors are members of the Centre of Research Excellence in Rural and Remote Primary Health Care, conducting research in accessible and equitable primary health service provision in rural and remote Australia; and members of the Centre for Research Excellence in Medical Workforce Dynamics. The research reported in this paper is a project of the Australian Primary Health Care Research Institute (APHCRI), which is supported by a grant from the Australian Government Department of Health and Ageing. The information and opinions contained in it do not necessarily reflect the views or policy of the Australian Primary Health Care Research Institute or the Australian Government Department of Health and Ageing. All authors made substantial contributions to the conception of this paper and to drafting the paper. All authors agree to be accountable for all aspects of the work in this paper and have given their approval for submission of the paper in its current state. This research has not been previously published in part or full elsewhere.
Publisher Copyright:
© 2016 National Rural Health Alliance Inc.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Objective: To synthesise key Australian empirical rural retention evidence and outline implications and potential applications for policymaking. Design: A comprehensive search of Medline, PsychINFO, CINAHL plus, Scopus and EMBASE revealed eight peer-reviewed empirical studies published since 2000 quantifying factors associated with actual retention. Setting and participants: Rural and remote Australian primary health care workers. Main outcome measures: Hazard ratios (hazard of leaving rural), mean length of stay in current rural position and odds ratios (odds of leaving rural). Results: A broad range of geographical, professional, financial, educational, regulatory and personal factors are strongly and significantly associated with the rural retention of Australian primary health care workers. Important factors included geographical remoteness and population size, profession, providing hospital services, practising procedural skills, taking annual leave, employment grade, employment and payment structures, restricted access to provider numbers, country of training, vocational training, practitioner age group and cognitive behavioural coaching. These findings suggest that retention strategies should be multifaceted and ‘bundled’, addressing the combination of modifiable factors most important for specific groups of Australian rural and remote primary health care workers, and compensating health professionals for hardships they face that are linked to less modifiable factors. Conclusions: The short retention of many Australian rural and remote Allied Health Professionals and GPs, particularly in small, outer regional and remote communities, requires ongoing policy support. The important retention patterns highlighted in this review provide policymakers with direction about where to best target retention initiatives, as well as an indication of what they can do to improve retention.
AB - Objective: To synthesise key Australian empirical rural retention evidence and outline implications and potential applications for policymaking. Design: A comprehensive search of Medline, PsychINFO, CINAHL plus, Scopus and EMBASE revealed eight peer-reviewed empirical studies published since 2000 quantifying factors associated with actual retention. Setting and participants: Rural and remote Australian primary health care workers. Main outcome measures: Hazard ratios (hazard of leaving rural), mean length of stay in current rural position and odds ratios (odds of leaving rural). Results: A broad range of geographical, professional, financial, educational, regulatory and personal factors are strongly and significantly associated with the rural retention of Australian primary health care workers. Important factors included geographical remoteness and population size, profession, providing hospital services, practising procedural skills, taking annual leave, employment grade, employment and payment structures, restricted access to provider numbers, country of training, vocational training, practitioner age group and cognitive behavioural coaching. These findings suggest that retention strategies should be multifaceted and ‘bundled’, addressing the combination of modifiable factors most important for specific groups of Australian rural and remote primary health care workers, and compensating health professionals for hardships they face that are linked to less modifiable factors. Conclusions: The short retention of many Australian rural and remote Allied Health Professionals and GPs, particularly in small, outer regional and remote communities, requires ongoing policy support. The important retention patterns highlighted in this review provide policymakers with direction about where to best target retention initiatives, as well as an indication of what they can do to improve retention.
KW - Allied Health Personnel
KW - General Practitioners
KW - health manpower
KW - health policy
KW - retention
KW - rural health services
UR - http://www.scopus.com/inward/record.url?scp=84963533721&partnerID=8YFLogxK
U2 - 10.1111/ajr.12294
DO - 10.1111/ajr.12294
M3 - Article
C2 - 27087590
AN - SCOPUS:84963533721
VL - 25
SP - 5
EP - 14
JO - Australian Journal of Rural Health
JF - Australian Journal of Rural Health
SN - 1038-5282
IS - 1
ER -