Determinants of rural Australian primary health care worker retention: A synthesis of key evidence and implications for policymaking

Deborah J Russell; Matthew R McGrail; John S Humphreys

doi:10.1111/ajr.12294

Determinants of rural Australian primary health care worker retention: A synthesis of key evidence and implications for policymaking

Aust J Rural Health. 2017 Feb;25(1):5-14. doi: 10.1111/ajr.12294. Epub 2016 Apr 18.

Authors

Deborah J Russell^{1

2

3}, Matthew R McGrail^{2

3

4}, John S Humphreys^{1

2

3}

Affiliations

¹ Office of Research, School of Rural Health, Monash University, Bendigo.
² Centre of Research Excellence (CRE) in Rural and Remote Primary Health Care, Bendigo, Victoria, Australia.
³ Centre of Research Excellence (CRE) in Medical Workforce Dynamics, Melbourne, Victoria, Australia.
⁴ Gippsland Medical School, Monash University, Churchill, Victoria, Australia.

PMID: 27087590
DOI: 10.1111/ajr.12294

Abstract

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.

Keywords: Allied Health Personnel; General Practitioners; health manpower; health policy; retention; rural health services.

Publication types

Review

MeSH terms

Australia
Employment / statistics & numerical data*
Female
Humans
Job Satisfaction*
Male
Personnel Turnover / statistics & numerical data*
Primary Health Care
Rural Health Services*
Rural Population / statistics & numerical data*
Workforce