Dataset Information

Retention of the rural allied health workforce in New South Wales: a comparison of public and private practitioners.

ABSTRACT:

Background

Policy initiatives to improve retention of the rural health workforce have relied primarily on evidence for rural doctors, most of whom practice under a private business model. Much of the literature for rural allied health (AH) workforce focuses on the public sector. The AH professions are diverse, with mixed public, private or combined practice settings. This study explores sector differences in factors affecting retention of rural AH professionals.

Methods

This study compared respondents from the 2008 Rural Allied Health Workforce (RAHW) survey recruiting all AH professionals in rural New South Wales. Comparisons between public (n = 833) and private (n = 756) groups were undertaken using Chi square analysis to measure association for demographics, job satisfaction and intention to leave. The final section of the RAHW survey comprised 33 questions relating to retention. A factor analysis was conducted for each cohort. Factor reliability was assessed and retained factors were included in a binary logistic regression analysis for each cohort predicting intention to leave.

Results

Six factors were identified: professional isolation, participation in community, clinical demand, taking time away from work, resources and 'specialist generalist' work. Factors differed slightly between groups. A seventh factor (management) was present only in the public cohort. Gender was not a significant predictor of intention to leave. Age group was the strongest predictor of intention to leave with younger and older groups being significantly more likely to leave than middle aged.In univariate logistic analysis (after adjusting for age group), the ability to get away from work did not predict intention to leave in either group. In multivariate analysis, high clinical demand predicted intention to leave in both the public (OR = 1.40, 95% CI = 1.08, 1.83) and private (OR = 1.61, 95% CI = 1.15, 2.25) cohorts. Professional isolation (OR = 1.39. 95% CI = 1.11, 1.75) and Participation in community (OR = 1.57, 95% CI = 1.13, 2.19) also contributed to the model in the public cohort.

Conclusions

This paper demonstrates differences between those working in public versus private sectors and suggests that effectiveness of policy initiatives may be improved through better targeting.

SUBMITTER: Keane S

PROVIDER: S-EPMC3599445 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

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Publications

Retention of the rural allied health workforce in New South Wales: a comparison of public and private practitioners.

Keane Sheila S Lincoln Michelle M Rolfe Margaret M Smith Tony T

BMC health services research 20130127

<h4>Background</h4>Policy initiatives to improve retention of the rural health workforce have relied primarily on evidence for rural doctors, most of whom practice under a private business model. Much of the literature for rural allied health (AH) workforce focuses on the public sector. The AH professions are diverse, with mixed public, private or combined practice settings. This study explores sector differences in factors affecting retention of rural AH professionals.<h4>Methods</h4>This study ...[more]

PMID: 23351491

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Project description:BackgroundNaturopathy forms an increasingly significant part of the Australian healthcare setting, with high utilisation of naturopaths by the Australian public and a large therapeutic footprint in rural and regional Australia. However, despite these circumstances, there has been little exploration of the interface between naturopathy providers and conventional primary health care practitioners in rural and regional Australia. The study reported here examined the referral practices and factors that underlie referral to naturopaths amongst a sample of rural and regional Australian general practitioners (GPs).MethodsA 27-item questionnaire was sent to all 1,486 GPs currently practising in rural and regional Divisions of General Practice in New South Wales, Australia.ResultsA total of 585 GPs responded to the questionnaire, with 49 questionnaires returned as "no longer at this address" (response rate: 40.7%). One-quarter of GPs (25.8%) referred to a naturopath at least a few times per year while nearly half (48.8%) stated that they would not refer to a naturopath under any circumstances. GPs were more likely to refer to a naturopath if the GP: was not initially from a rural area (OR=1.78; 95% CI: 0.95, 3.33); believes in the efficacy of naturopathy (OR=5.62; 95% CI: 2.42, 11.36); has seen positive results from naturopathy previously (OR=2.61; 95% CI: 1.35, 5.05); perceives a lack of other treatment options for their patient (OR=5.25; 95% CI: 2.42; 11.36); uses peer-reviewed literature as their major source of CAM information (OR=3.03; 95% CI: 1.65, 5.55); uses CAM practitioners as a major source of CAM information (OR=6.09; 95% CI: 2.91, 12.72); and does not have an existing relationship with any CAM provider (OR=3.03; 95% CI: 1.53, 6.25).ConclusionsThere is little interaction (both via referrals as well as the development of professional relationships) between the naturopathic and GP communities in rural and regional Australia, with significant levels of both support and opposition for naturopathic referral amongst GPs. The significant presence and high utilisation of naturopathy in rural primary health care, which appears to work in parallel to conventional medical care rather than in conjunction with it, should serve as an impetus for increased research into naturopathy practice, policy and regulation in rural and regional health.

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Dataset Information

Retention of the rural allied health workforce in New South Wales: a comparison of public and private practitioners.

Background

Methods

Results

Conclusions

Publications

Retention of the rural allied health workforce in New South Wales: a comparison of public and private practitioners.

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