농촌 및 외딴 지역에서 일차의료에 종사하는 인력들의 이상적 고용기간(length of employment)는 얼마인가? (호주 연구 결과)

What is a reasonable length of employment for health workers in Australian rural and remote primary healthcare services?

Deborah Jane Russell1,2,4 MBBS, MClinEpid, FRACGP, Research Fellow

John Wakerman1,3 MBBS, MTH, FAFPHM, FACRRM, Professor, Director

John Stirling Humphreys1,2 BA(Hons), DipEd, PhD, Emeritus Professor

o 배경

¡ 농촌 및 외딴 지역의 일차의료인력(PHC)을 최적화하기 위해서는 해당지역에 머무는 기간이 얼마나 되며, 무슨 요인에 의해서 달라지는가를 이해하는 것이 중요함.

¡ 현재로서는 retention 패턴에 대한 지식이 제한적이고, 다양한 지역적 맥락과 직종에 따른 PHC인력 배치의 기준(benchmarks)이 부족함.

 

¡ 합리적인 근무유지 기간(reasonable length of stay)의 기준선(benchmarks)을 제시하기 위해서 크게 세 가지 전략을 활용함

- a comprehensive literature review of PHC workforce-retention indicators and benchmarks;

- secondary analysis of existing Australian PHC workforce datasets; and

- a postal survey of 108 rural and remote PHC services,

 

o 결과 및 결론

¡ 문헌 조사와 이차 자료 분석으로부터는 유용한 자료를 얻을 수 없었으나, 일차 자료 분석을 통해서 지역과 직종에 따른 retention의 차이를 알 수 있었음.

¡ 첫 6달까지는 유사했으나 그 이후부터 24개월(2년)까지의 차이가 컸으며, 이 자료를 근거로 임시적인 기준선을 제안하였음.

¡ 지역과 직종에 따른 의료인력 유지의 기준선은 경험적으로 계산될 수 있으며, 이를 통해 retention performance를 높이고, 직원 교체(staff replacement)에 따른 비용 절감의 기회로 활용 가능함.

 

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Aust Health Rev. 2013 May;37(2):256-61. doi: 10.1071/AH12184.

What is a reasonable length of employment for health workers in Australian rural and remote primary healthcare services?

Russell DJ1, Wakerman J, Humphreys JS.

Author information

Abstract

BACKGROUND:

Optimising retention of rural and remote primary healthcare (PHC) workers requires workforce planners to understand what constitutes a reasonable length of employment and how this varies. Currently, knowledge of retention patterns is limited and there is an absence of PHC workforce benchmarks that take account of differences in geographic context and profession.

METHODS:

Three broad strategies were employed for proposing benchmarks for reasonable length of stay. They comprised: a comprehensive literature review of PHC workforce-retention indicators and benchmarks; secondary analysis of existing Australian PHC workforce datasets; and a postal survey of 108 rural and remote PHC services, identifying perceived and actual workforce-retention patterns of selected professional groups.

RESULTS:

The literature review and secondary data analysis revealed little that was useful for establishing retention benchmarks. Analysis of primary data revealed differences in retention by geographic location and profession that took time to emerge and were not sustained indefinitely. Provisional benchmarks for reasonable length of employment were developed for health professional groups in both rural and remote settings.

CONCLUSIONS:

Workforce-retention benchmarks that differ according to geographic location and profession can be empirically derived, facilitating opportunities for managers to improve retention performance and reduce the high costs of staff replacement. WHAT IS KNOWN ABOUT THE TOPIC?Health services located in small rural and remote locations are likely to continue to experience workforce shortages and high costs of recruitment.Health workforce retention is therefore crucial. However, effective rural health workforce planning and use of strategies to maximise retention of existing health workers is hindered by inadequate knowledge about baseline employment-retention patterns. WHAT DOES THIS PAPER ADD? Differences in health worker retention patterns by geographic location and profession are most evident after the first 6 months through until the end of the second year of employment. Health worker-retention benchmarks that differ according to geographic location and profession are proposed. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Benchmarking workforce retention in comparable health services can enable identification of best practice and the underpinning retention strategies. Workforce planners can use this, together with knowledge of baseline retention patterns and the high cost of staff replacement, to guide the design, timing and implementation of cost-neutral retention strategies.

PMID:

 

23497824

 

[PubMed - indexed for MEDLINE]