Abstract
Background: Delivering effective primary care to where it’s needed most – specifically remote Aboriginal communities – is hampered by high turnover and low stability of health centre staff and a lack of evidence about this to inform remote workforce policy making. This research describes the turnover, stability and employment survival patterns over 12 years in remote Northern Territory (NT) health centres.
Methods: Descriptive statistics and marginal structural analysis of Department of Health payroll data, 2004-2015, for all staff based at 54 government-run remote NT health centres. Main outcome measures were annual turnover rates, 12-month stability rates and employment survival probabilities. Outcomes were investigated by health centre, calendar year, professional discipline, geographical remoteness and the periods before and after the NT Emergency Response in 2007.
Results: Annual turnover rates for all staff combined averaged 118% (95% confidence interval (CI) 113-124%), declining significantly over time (175% in 2004 to 92% in 2015; p<0.05). Turnover rates were significantly lower after the NT Emergency Response (66% lower, 95%CI 48-85%). Stability rates increased for all staff combined (41% in 2004 to 51% in 2015; χ2=12.5, p<0.001), averaging 49% overall (95%CI 42-56%). The most stable health centre had a mean 12-month stability rate for all staff that was 6 times higher than the least stable health centre (11% versus 66%, χ2=35.6, p<0.01).
Aboriginal Health Practitioners had significantly lower annual turnover rates (53%; 95%CI 46-61%) and higher probability of remaining employed 12 months after commencing employment (0.53; 95%CI 0.46-0.59) compared to other professional groups.
Nurses employed directly by the Department of Health had significantly higher annual turnover rates (150%; 95%CI 141-160%) than other professional groups, with no improvement over time. If unit level agency-employed nurse data were included in turnover calculations, nurse turnover almost certainly would have increased over the study period.
Methods: Descriptive statistics and marginal structural analysis of Department of Health payroll data, 2004-2015, for all staff based at 54 government-run remote NT health centres. Main outcome measures were annual turnover rates, 12-month stability rates and employment survival probabilities. Outcomes were investigated by health centre, calendar year, professional discipline, geographical remoteness and the periods before and after the NT Emergency Response in 2007.
Results: Annual turnover rates for all staff combined averaged 118% (95% confidence interval (CI) 113-124%), declining significantly over time (175% in 2004 to 92% in 2015; p<0.05). Turnover rates were significantly lower after the NT Emergency Response (66% lower, 95%CI 48-85%). Stability rates increased for all staff combined (41% in 2004 to 51% in 2015; χ2=12.5, p<0.001), averaging 49% overall (95%CI 42-56%). The most stable health centre had a mean 12-month stability rate for all staff that was 6 times higher than the least stable health centre (11% versus 66%, χ2=35.6, p<0.01).
Aboriginal Health Practitioners had significantly lower annual turnover rates (53%; 95%CI 46-61%) and higher probability of remaining employed 12 months after commencing employment (0.53; 95%CI 0.46-0.59) compared to other professional groups.
Nurses employed directly by the Department of Health had significantly higher annual turnover rates (150%; 95%CI 141-160%) than other professional groups, with no improvement over time. If unit level agency-employed nurse data were included in turnover calculations, nurse turnover almost certainly would have increased over the study period.
| Original language | English |
|---|---|
| Title of host publication | Proceedings of the 15th National Rural Health Conference |
| Editors | Leanne Coleman |
| Place of Publication | Deakin West, ACT |
| Publisher | National Rural Health Alliance |
| Pages | 1-11 |
| Number of pages | 11 |
| Publication status | Published - 2019 |
| Event | 15th National Rural Health Conference - Hotel Gran Chancellor, Hobart, Australia Duration: 24 Mar 2019 → 27 Mar 2019 Conference number: 15 https://www.crrmh.com.au/event/15th-national-rural-health-conference-hobart/ |
Conference
| Conference | 15th National Rural Health Conference |
|---|---|
| Country/Territory | Australia |
| City | Hobart |
| Period | 24/03/19 → 27/03/19 |
| Internet address |