Skip to main content
Top
Published in: Human Resources for Health 1/2013

Open Access 01-12-2013 | Research

Attitudes toward working in rural areas of Thai medical, dental and pharmacy new graduates in 2012: a cross-sectional survey

Authors: Noppakun Thammatacharee, Rapeepong Suphanchaimat, Thunthita Wisaijohn, Supon Limwattananon, Weerasak Putthasri

Published in: Human Resources for Health | Issue 1/2013

Login to get access

Abstract

Background

Inequity in health workforce distribution has been a national concern of the Thai health service for decades. The government has launched various policies to increase the distribution of health workforces to rural areas. However, little is known regarding the attitudes of health workers and the factors influencing their decision to work in rural areas. This study aimed to explore the current attitudes of new medical, dental and pharmacy graduates as well as determine the linkage between their characteristics and the preference for working in rural areas.

Methods

A cross-sectional survey was conducted, using self-administered questionnaires, with a total of 1,225 medical, dental and pharmacy graduates. They were participants of the meeting arranged by the Ministry of Public Health (MOPH) on 1–2 April 2012. Descriptive statistics using mean and percentage, and inferential statistics using logistic regression with marginal effects, were applied for data analysis.

Results

There were 754 doctors (44.4%), 203 dentists (42.6%) and 268 pharmacists (83.8%) enrolled in the survey. Graduates from all professions had positive views towards working in rural areas. Approximately 22% of doctors, 31% of dentists and 52% of pharmacists selected ‘close proximity to hometown’ as the most important reason for workplace selection. The multivariable analysis showed a variation in attributes associated with the tendency to work in rural areas across professions. In case of doctors, special track graduates had a 10% higher tendency to prefer rural work than those recruited through the national entrance examination.

Conclusions

The majority of graduates chose to work in community hospitals, and attitudes towards rural work were quite positive. In-depth analysis found that factors influencing their choice varied between professions. Special track recruitment positively influenced the selection of rural workplaces among new doctors attending the MOPH annual meeting for workplace selection. This policy innovation should be applied to dentists and pharmacists as well. However, implementing a single policy without supporting strategies, or failing to consider different characteristics between professions, might not be effective. Future study of attitudes and factors contributing to the selection of, and retention in, rural service of both new graduates and in-service professionals was recommended.
Appendix
Available only for authorised users
Literature
1.
go back to reference World Health Organization: The world health report 2006 – working together for health. 2006, Geneva: WHO World Health Organization: The world health report 2006 – working together for health. 2006, Geneva: WHO
2.
go back to reference Savigny D, Adam T: Systems thinking for health systems strengthening: An introduction. 2009, Geneva: World Health Organization, 1 Savigny D, Adam T: Systems thinking for health systems strengthening: An introduction. 2009, Geneva: World Health Organization, 1
3.
go back to reference Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH: Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002, 288: 1987-1993. 10.1001/jama.288.16.1987.CrossRefPubMed Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH: Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002, 288: 1987-1993. 10.1001/jama.288.16.1987.CrossRefPubMed
4.
go back to reference Lehmann U, Dieleman M, Martineau T: Staffing remote rural areas in middle-and low-income countries: a literature review of attraction and retention. BMC Health Serv Res. 2008, 8: 19-10.1186/1472-6963-8-19.CrossRefPubMedPubMedCentral Lehmann U, Dieleman M, Martineau T: Staffing remote rural areas in middle-and low-income countries: a literature review of attraction and retention. BMC Health Serv Res. 2008, 8: 19-10.1186/1472-6963-8-19.CrossRefPubMedPubMedCentral
5.
go back to reference Wibulpolprasert S, Pengpaibon P: Integrated strategies to tackle the inequitable distribution of doctors in Thailand: four decades of experience. Hum Resour Health. 2003, 1: 12-10.1186/1478-4491-1-12.CrossRefPubMedPubMedCentral Wibulpolprasert S, Pengpaibon P: Integrated strategies to tackle the inequitable distribution of doctors in Thailand: four decades of experience. Hum Resour Health. 2003, 1: 12-10.1186/1478-4491-1-12.CrossRefPubMedPubMedCentral
6.
go back to reference Suphanchaimat R, Wisaijohn T, Thammathacharee N, Tangcharoensathien V: Projecting Thailand physician supplies between 2012 and 2030: application of cohort approaches. Hum Resour Health. 2013, 11: 3-10.1186/1478-4491-11-3.CrossRefPubMedPubMedCentral Suphanchaimat R, Wisaijohn T, Thammathacharee N, Tangcharoensathien V: Projecting Thailand physician supplies between 2012 and 2030: application of cohort approaches. Hum Resour Health. 2013, 11: 3-10.1186/1478-4491-11-3.CrossRefPubMedPubMedCentral
7.
go back to reference Patcharanarumol W, Tangcharoensathien V, Limwattananon S, Panichkriangkrai W, Pachanee K, Poungkantha W, Gilson L, Mills A: Why and how did Thailand achieve good health at low cost?. ‘Good health at low cost’ 25 years on What makes a successful health system?. Edited by: Balabanova D, McKee M, Mills A. 2011, London: London School of Hygiene & Tropical Medicine, 193-223. 1 Patcharanarumol W, Tangcharoensathien V, Limwattananon S, Panichkriangkrai W, Pachanee K, Poungkantha W, Gilson L, Mills A: Why and how did Thailand achieve good health at low cost?. ‘Good health at low cost’ 25 years on What makes a successful health system?. Edited by: Balabanova D, McKee M, Mills A. 2011, London: London School of Hygiene & Tropical Medicine, 193-223. 1
8.
go back to reference Wibulpolprasert S, Pachanee C: Addressing the internal brain drain of medical doctors in Thailand: the story and lesson learned. Global Soc Policy. 2008, 8: 12-15. 10.1177/14680181080080010104.CrossRef Wibulpolprasert S, Pachanee C: Addressing the internal brain drain of medical doctors in Thailand: the story and lesson learned. Global Soc Policy. 2008, 8: 12-15. 10.1177/14680181080080010104.CrossRef
9.
go back to reference Faramnuayphol P: Thai Health System. Thailand health profile 2005–2007. Edited by: Wibulpolprasert S. 2007, Bangkok: Bureau of Policy and Strategy, Ministry of Public Health Faramnuayphol P: Thai Health System. Thailand health profile 2005–2007. Edited by: Wibulpolprasert S. 2007, Bangkok: Bureau of Policy and Strategy, Ministry of Public Health
10.
go back to reference World Health Organization: Increasing access to health workers in remote and rural areas through improved retention: global policy recommendations. 2010, Geneva: WHO World Health Organization: Increasing access to health workers in remote and rural areas through improved retention: global policy recommendations. 2010, Geneva: WHO
11.
go back to reference Rabinowitz HK, Diamond JJ, Markham FW, Wortman JR: Medical school programs to increase the rural physician supply: a systematic review and projected impact of widespread replication. Acad Med. 2008, 83: 235-243. 10.1097/ACM.0b013e318163789b.CrossRefPubMed Rabinowitz HK, Diamond JJ, Markham FW, Wortman JR: Medical school programs to increase the rural physician supply: a systematic review and projected impact of widespread replication. Acad Med. 2008, 83: 235-243. 10.1097/ACM.0b013e318163789b.CrossRefPubMed
12.
go back to reference Chan BTB, Degani N, Crichton T, Pong RW, Rourke JT, Goertzen J, McCready B: Factors influencing family physicians to enter rural practice: does rural or urban background make a difference?. CanadFamPhys. 2005, 51: 1246-1247. Chan BTB, Degani N, Crichton T, Pong RW, Rourke JT, Goertzen J, McCready B: Factors influencing family physicians to enter rural practice: does rural or urban background make a difference?. CanadFamPhys. 2005, 51: 1246-1247.
13.
go back to reference Matsumoto M, Inoue K, Kajii E: Characteristics of medical students with rural origin: implications for selective admission policies. Health Policy. 2008, 87: 194-202. 10.1016/j.healthpol.2007.12.006.CrossRefPubMed Matsumoto M, Inoue K, Kajii E: Characteristics of medical students with rural origin: implications for selective admission policies. Health Policy. 2008, 87: 194-202. 10.1016/j.healthpol.2007.12.006.CrossRefPubMed
14.
go back to reference Nomura K, Yano E, Mizushima S, Endo H, Aoki M, Shinozaki H, Fukui T: The shift of residents from university to non-university hospitals in Japan: a survey study. J Gen Intern Med. 2008, 23: 1105-1109. 10.1007/s11606-008-0644-7.CrossRefPubMedPubMedCentral Nomura K, Yano E, Mizushima S, Endo H, Aoki M, Shinozaki H, Fukui T: The shift of residents from university to non-university hospitals in Japan: a survey study. J Gen Intern Med. 2008, 23: 1105-1109. 10.1007/s11606-008-0644-7.CrossRefPubMedPubMedCentral
15.
go back to reference Inoue K, Hirayama Y, Igarashi M: A medical school for rural areas. Med Educ. 1997, 31: 430-434. 10.1046/j.1365-2923.1997.00699.x.CrossRefPubMed Inoue K, Hirayama Y, Igarashi M: A medical school for rural areas. Med Educ. 1997, 31: 430-434. 10.1046/j.1365-2923.1997.00699.x.CrossRefPubMed
16.
go back to reference Lertsukprasert S: Collaborative Project to increase production of rural doctor to tavle physician shortage problem of ministry of public health. J Health Sci. 2008, 17: 1906-1914. Lertsukprasert S: Collaborative Project to increase production of rural doctor to tavle physician shortage problem of ministry of public health. J Health Sci. 2008, 17: 1906-1914.
17.
go back to reference Kongkam L, Pagaiya N, Srirattana S: Production of graduates from the Collaborative Project to Increase Production of Rural Doctor (CPIRD). 2011, Human Resources for Health Research and Development Office: Nonthaburi Kongkam L, Pagaiya N, Srirattana S: Production of graduates from the Collaborative Project to Increase Production of Rural Doctor (CPIRD). 2011, Human Resources for Health Research and Development Office: Nonthaburi
19.
go back to reference Pagaiya N: Impact of Universal Coverage Scheme (UCS) on Health Workforce. 2011, Health System Research Institute: Nonthaburi Pagaiya N: Impact of Universal Coverage Scheme (UCS) on Health Workforce. 2011, Health System Research Institute: Nonthaburi
20.
go back to reference Pagaiya N: Situation of health professions. Human Resources for Health: history, current situtation, and the way forward. Edited by: Pagaiya N, Hongthong P. 2011, Nonthaburi: Human Resources for Health Research and Development Office, 1 Pagaiya N: Situation of health professions. Human Resources for Health: history, current situtation, and the way forward. Edited by: Pagaiya N, Hongthong P. 2011, Nonthaburi: Human Resources for Health Research and Development Office, 1
21.
go back to reference Prakongsai P, Limwattananon S, Tangcharoensathien V: The equity impact of the universal coverage policy: lessons from Thailand. Adv Health Econ Health Serv Res. 2009, 21: 57-81.PubMed Prakongsai P, Limwattananon S, Tangcharoensathien V: The equity impact of the universal coverage policy: lessons from Thailand. Adv Health Econ Health Serv Res. 2009, 21: 57-81.PubMed
22.
go back to reference Thammarangsri T: Policy Recommendation on Geographical of Physician’s Distribution under Universal Coverage Health Insurance. 2005, Health Insurance System Research Office: Nonthaburi Thammarangsri T: Policy Recommendation on Geographical of Physician’s Distribution under Universal Coverage Health Insurance. 2005, Health Insurance System Research Office: Nonthaburi
23.
go back to reference Noree T: Fact sheet: the situation on physician attrition from hospitals under the Office of the Permanent Secretary. 2008, Nonthabri: International Health Policy Programme, Ministry of Public Health Noree T: Fact sheet: the situation on physician attrition from hospitals under the Office of the Permanent Secretary. 2008, Nonthabri: International Health Policy Programme, Ministry of Public Health
24.
go back to reference Faramnuayphol P, Ekachampaka P, Wattanamano N: Chapter 6: Health services in Thailand. Thailand Health Profile 2008–2010. Edited by: Wibulpolprasert S. 2011, Nonthaburi: Veteran Press, 233-309. Faramnuayphol P, Ekachampaka P, Wattanamano N: Chapter 6: Health services in Thailand. Thailand Health Profile 2008–2010. Edited by: Wibulpolprasert S. 2011, Nonthaburi: Veteran Press, 233-309.
25.
go back to reference Pagaiya N, Tangcharoensathien V, Kasemsub V, Chantanis A, Srirattana S, Wongwinyu K: Attitude and rural job of choices of newly graduated doctors. J Health Syst Res. 2012, 6: 30-39. Pagaiya N, Tangcharoensathien V, Kasemsub V, Chantanis A, Srirattana S, Wongwinyu K: Attitude and rural job of choices of newly graduated doctors. J Health Syst Res. 2012, 6: 30-39.
26.
go back to reference Pagaiya N: Increaing the lump sum allowance and conflict between professions. Human Resources for Health: history, current situtation, and the way forward. Edited by: Pagaiya N, Hongthong P. 2011, Nonthaburi: Human Resources for Health Research and Development Office, 110- Pagaiya N: Increaing the lump sum allowance and conflict between professions. Human Resources for Health: history, current situtation, and the way forward. Edited by: Pagaiya N, Hongthong P. 2011, Nonthaburi: Human Resources for Health Research and Development Office, 110-
28.
go back to reference Suphanchaimat R, Topothai T, Thaichinda C, Pagaiya N, Kasemsub V, Wisaijohn T: New medical graduates’ confidence in medical and public-health competency: exploratory factor analysis and multiple regression. J Health Syst Res. 2012, 6: 455-466. Suphanchaimat R, Topothai T, Thaichinda C, Pagaiya N, Kasemsub V, Wisaijohn T: New medical graduates’ confidence in medical and public-health competency: exploratory factor analysis and multiple regression. J Health Syst Res. 2012, 6: 455-466.
29.
go back to reference Rabinowitz HK, Diamond JJ, Markham FW, Paynter NP: Critical factors for designing programs to increase the supply and retention of rural primary care physicians. JAMA. 2001, 286: 1041-1048. 10.1001/jama.286.9.1041.CrossRefPubMed Rabinowitz HK, Diamond JJ, Markham FW, Paynter NP: Critical factors for designing programs to increase the supply and retention of rural primary care physicians. JAMA. 2001, 286: 1041-1048. 10.1001/jama.286.9.1041.CrossRefPubMed
30.
go back to reference Wilkinson D, Laven G, Pratt N, Beilby J: Impact of undergraduate and postgraduate rural training and medical school entry criteria on rural practice among Australian general practitioners: national study of 2414 doctors. Med Educ. 2003, 37: 809-814. 10.1046/j.1365-2923.2003.01596.x.CrossRefPubMed Wilkinson D, Laven G, Pratt N, Beilby J: Impact of undergraduate and postgraduate rural training and medical school entry criteria on rural practice among Australian general practitioners: national study of 2414 doctors. Med Educ. 2003, 37: 809-814. 10.1046/j.1365-2923.2003.01596.x.CrossRefPubMed
31.
go back to reference Eley DS: Junior doctors’ perceptions of their preparedness for hospital work: Support for the rural clinical school model as a key to better preparation. Med J Australia. 2010, 192: 109-PubMed Eley DS: Junior doctors’ perceptions of their preparedness for hospital work: Support for the rural clinical school model as a key to better preparation. Med J Australia. 2010, 192: 109-PubMed
32.
go back to reference Eley DS: Postgraduates’ perceptions of preparedness for work as a doctor and making future career decisions: support for rural, non-traditional medical schools. Educ Health (Abingdon). 2010, 23: 374- Eley DS: Postgraduates’ perceptions of preparedness for work as a doctor and making future career decisions: support for rural, non-traditional medical schools. Educ Health (Abingdon). 2010, 23: 374-
33.
go back to reference Wilson N, Bouhuijs P, Conradie H, Reuter H, Van Heerden B, Marais B: Perceived educational value and enjoyment of a rural clinical rotation for medical students. Rural Remote Health. 2008, 8: 999-PubMed Wilson N, Bouhuijs P, Conradie H, Reuter H, Van Heerden B, Marais B: Perceived educational value and enjoyment of a rural clinical rotation for medical students. Rural Remote Health. 2008, 8: 999-PubMed
34.
go back to reference Kongkam L: Review of medical graadute production systems in response to health systems and health needs of the population. 2007, Nonthaburi: Health Systems Research Institute, 72- Kongkam L: Review of medical graadute production systems in response to health systems and health needs of the population. 2007, Nonthaburi: Health Systems Research Institute, 72-
35.
go back to reference Pagaiya N, Kongkam L, Worarat W, Sriratana S, Wongwinyou K: Rural retention of medical graduates trained by the collaborative project to increase rural doctors (CPIRD). J Health Syst Res. 2012, 6: 219-227. Pagaiya N, Kongkam L, Worarat W, Sriratana S, Wongwinyou K: Rural retention of medical graduates trained by the collaborative project to increase rural doctors (CPIRD). J Health Syst Res. 2012, 6: 219-227.
Metadata
Title
Attitudes toward working in rural areas of Thai medical, dental and pharmacy new graduates in 2012: a cross-sectional survey
Authors
Noppakun Thammatacharee
Rapeepong Suphanchaimat
Thunthita Wisaijohn
Supon Limwattananon
Weerasak Putthasri
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2013
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/1478-4491-11-53

Other articles of this Issue 1/2013

Human Resources for Health 1/2013 Go to the issue