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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Factors affecting turnover intentions among public hospital doctors in a middle-level city in central China

Fengfan Zhang A , Zhenni Luo B , Ting Chen A , Rui Min A and Pengqian Fang A C
+ Author Affiliations
- Author Affiliations

A School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan 430030, China. Email: zhang1211@126.com; li_chenting@hust.edu.cn; ruimin0801@163.com

B School of Health Management, Guangzhou Medical University, 195 Dongfeng West Road, Yuexiu District, Guangzhou 510182, China. Email: janerowe@163.com

C Corresponding author. Email: pfang@mails.tjmu.edu.cn

Australian Health Review 41(2) 214-221 https://doi.org/10.1071/AH15238
Submitted: 18 December 2015  Accepted: 2 March 2016   Published: 28 April 2016

Abstract

Objective The aim of the present study was to explore prominent factors affecting turnover intentions among public hospital doctors in urban areas, particularly in Xiangyang City, Hubei Province, a middle-level city in central China.

Methods Questionnaires were used to collect data from 284 public hospital doctors. Pearson’s Chi-squared was used to assess whether sociodemographic and other factors were related to the turnover intentions of public hospital doctors. Binary logistic regression was performed to determine the significant factors that influence turnover intentions.

Results The analysis revealed that 28.2% of public hospital doctors intended to leave the hospital where they were currently employed. Dissatisfaction with working conditions and hospital management processes, as well as work pressures, were significant factors contributing to the turnover intentions of public hospital doctors.

Conclusion Research into turnover intentions indicates that public hospital doctors surveyed in urban China give greater weight to their professional environment and career development rather than salary in their employment decisions.

What is known about the topic? Turnover of medical staff is a concern to hospital administrators because it is costly and detrimental to organisational performance and quality of care. Most studies have focused on the effects of individual and organisational factors on nurses’ intentions to leave their employment. Income dissatisfaction was one of the determining factors of turnover intentions in previous studies.

What does this paper add? The satisfaction of public hospital doctors with regard to income is not a determining factor of turnover intentions. In contrast with findings of previous studies, the doctors in public hospitals in urban China in the present study gave greater weight to their professional environment and career development in their employment decisions.

What are the implications for practitioners? The findings suggest that health service managers and policy makers should pay greater attention to the factors affecting public hospital doctors’ turnover intentions. This study will be useful for optimising public hospital management and minimising the turnover of doctors in China.

Additional keyword: job satisfaction.


References

[1]  Aiken LH, Sermeus W, Van den Heede K, et al Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ 2012; 344 e1717
| 22434089PubMed |

[2]  Bonenberger M, Aikins M, Akweongo P, Wyss K. The effects of health worker motivation and job satisfaction on turnover intention in Ghana: a cross-sectional study. Hum Resour Health 2014; 12 1–12.
The effects of health worker motivation and job satisfaction on turnover intention in Ghana: a cross-sectional study.Crossref | GoogleScholarGoogle Scholar |

[3]  Miao Y, Ye T, Qian D, Li J, Zhang L. Utilization of rural primary care physicians’ visit services for diabetes management of public health in southwestern China: a cross-sectional study from patients’ view. Iran J Public Health 2014; 4 769–77.

[4]  Wilson NA. Factors that affect job satisfaction and intention to leave of allied health professionals in a metropolitan hospital. Aust Health Rev 2015; 39 290–4.
Factors that affect job satisfaction and intention to leave of allied health professionals in a metropolitan hospital.Crossref | GoogleScholarGoogle Scholar | 25844982PubMed |

[5]  Blaauw D, Ditlopo P, Maseko F, et al Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. Glob Health Action 2013; 6 127–37.
Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa.Crossref | GoogleScholarGoogle Scholar |

[6]  Fang P, Luo Z, Fang Z. What is the job satisfaction and active participation of medical staff in public hospital reform: a study in Hubei province of China. Hum Resour Health 2015; 13 1–14.
What is the job satisfaction and active participation of medical staff in public hospital reform: a study in Hubei province of China.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC28XjtVyqsLY%3D&md5=6734dbdd6d4ed25f171837ed96b710e7CAS |

[7]  Seston E, Hassell K, Ferguson J, Hann M. Exploring the relationship between pharmacists’ job satisfaction, intention to quit the profession, and actual quitting. Res Social Adm Pharm 2009; 5 121–32.
Exploring the relationship between pharmacists’ job satisfaction, intention to quit the profession, and actual quitting.Crossref | GoogleScholarGoogle Scholar | 19524860PubMed |

[8]  Tham R, Buykx P, Kinsman L, et al Staff perceptions of primary healthcare service change: influences on staff satisfaction. Aust Health Rev 2014; 38 580–3.
Staff perceptions of primary healthcare service change: influences on staff satisfaction.Crossref | GoogleScholarGoogle Scholar | 25283371PubMed |

[9]  Li N, Li B, Dou J, Wang X. The anxiety and influence factor of the nurse students in different levels before the NCLEX-RN. Iran J Public Health 2015; 44 588–9.
| 26056680PubMed |

[10]  Zhang M, Zhang C, Sun Q, Cai Q, Yang H, Zhang Y. Questionnaire survey about use of an online appointment booking system in one large tertiary public hospital outpatient service center in China. BMC Med Inform Decis Mak 2014; 14 49
Questionnaire survey about use of an online appointment booking system in one large tertiary public hospital outpatient service center in China.Crossref | GoogleScholarGoogle Scholar | 24912568PubMed |

[11]  Shelledy DC, Mikles SP, May DF, Youtsey JW. Analysis of job satisfaction, burnout, and intent of respiratory care practitioners to leave the field or the job. Respir Care 1992; 37 46–60.
| 1:STN:280:DyaK387ltVKrsA%3D%3D&md5=b72a5ac24f9ad85233bc73943ccb4af3CAS | 10145581PubMed |

[12]  Tai TW, Bame SI, Robinson CD. Review of nursing turnover research, 1977–1996. Soc Sci Med 1998; 47 1905–24.
Review of nursing turnover research, 1977–1996.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M7ntlGmtQ%3D%3D&md5=d04faffdb59de8fd90062f4897172e6bCAS | 10075235PubMed |

[13]  Chen IH, Brown R, Bowers BJ, Chang WY. Job demand and job satisfaction in latent groups of turnover intention among licensed nurses in Taiwan nursing homes. Res Nurs Health 2015; 38 342–56.
Job demand and job satisfaction in latent groups of turnover intention among licensed nurses in Taiwan nursing homes.Crossref | GoogleScholarGoogle Scholar | 26012950PubMed |

[14]  Weisman CS, Alexander CS, Chase GA. Determinants of hospital staff nurse turnover. Med Care 1981; 19 431–43.
Determinants of hospital staff nurse turnover.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL3M7ps1Smtw%3D%3D&md5=beb4ec282705709fa419418eb4d7dbbeCAS | 7230936PubMed |

[15]  Kudo Y, Satoh T, Sinji H, et al Factors associated with turnover intention among nurses in small and medium-sized medical institutions. Environ Health Prev Med 2006; 11 128–35.
Factors associated with turnover intention among nurses in small and medium-sized medical institutions.Crossref | GoogleScholarGoogle Scholar | 21432387PubMed |

[16]  Kravitz RL. Physician job satisfaction as a public health issue. Isr J Health Policy Res 2012; 1 142–4.
Physician job satisfaction as a public health issue.Crossref | GoogleScholarGoogle Scholar |

[17]  Applebaum D, Fowler S, Fiedler N, Osinubi O, Robson M. The impact of environmental factors on nursing stress, job satisfaction, and turnover intention. J Nurs Adm 2010; 40 323–8.
The impact of environmental factors on nursing stress, job satisfaction, and turnover intention.Crossref | GoogleScholarGoogle Scholar | 20661062PubMed |

[18]  Yurumezoglu HA, Kocaman G. Pilot study for evidence-based nursing management: improving the levels of job satisfaction, organizational commitment, and intent to leave among nurses in Turkey. Nurs Health Sci 2012; 14 221–8.
Pilot study for evidence-based nursing management: improving the levels of job satisfaction, organizational commitment, and intent to leave among nurses in Turkey.Crossref | GoogleScholarGoogle Scholar |

[19]  Baernholdt M, Mark BA. The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. J Nurs Manag 2009; 17 994–1001.
The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units.Crossref | GoogleScholarGoogle Scholar | 19941573PubMed |

[20]  Boultinghouse OW, Hammack GG, Vo AH, Dittmar ML. Assessing physician job satisfaction and mental workload. Telemed J E Health 2007; 13 715–18.
Assessing physician job satisfaction and mental workload.Crossref | GoogleScholarGoogle Scholar | 18047420PubMed |

[21]  El-Jardali F, Dimassi H, Dumit N, Jamal D, Mouro G. A national cross-sectional study on nurses’ intent to leave and job satisfaction in Lebanon: implications for policy and practice. BMC Nurs 2009; 8 3
A national cross-sectional study on nurses’ intent to leave and job satisfaction in Lebanon: implications for policy and practice.Crossref | GoogleScholarGoogle Scholar | 19284613PubMed |

[22]  Faller MS, Gates MG, Georges JM, Connelly CD. Work-related burnout, job satisfaction, intent to leave, and nurse-assessed quality of care among travel nurses. J Nurs Adm 2011; 41 71–7.
Work-related burnout, job satisfaction, intent to leave, and nurse-assessed quality of care among travel nurses.Crossref | GoogleScholarGoogle Scholar | 21266885PubMed |

[23]  Pathman DE, Konrad TR, Williams ES, et al Physician job satisfaction, dissatisfaction, and turnover. J Fam Pract 2002; 51 593–9.
| 12160487PubMed |

[24]  Zhang Y, Feng X. The relationship between job satisfaction, burnout, and turnover intention among physicians from urban state-owned medical institutions in Hubei, China: a cross-sectional study. BMC Health Serv Res 2011; 11 1–13.
The relationship between job satisfaction, burnout, and turnover intention among physicians from urban state-owned medical institutions in Hubei, China: a cross-sectional study.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXnt1ykurY%3D&md5=027813c896b7508b4e92932e5555afb3CAS |

[25]  Warshawsky NE, Havens DS. Nurse manager job satisfaction and intent to leave. Nurs Econ 2014; 32 32–9.
| 24689156PubMed |

[26]  Strachota E, Normandin P, O’Brien N, Clary M, Krukow B. Reasons registered nurses leave or change employment status. J Nurs Adm 2003; 33 111–17.
Reasons registered nurses leave or change employment status.Crossref | GoogleScholarGoogle Scholar | 12584464PubMed |

[27]  Wells N, Roberts L, Medlin LC. Issues related to staff retention and turnover. Semin Nurse Manag 2002; 10 171–9.
| 12271763PubMed |