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Human Resources for Health
Published in: Human Resources for Health 1/2021

Open Access 01-12-2021 | Research

The prevalence of turnover intention and influencing factors among emergency physicians: a national observation

Authors: Shijiao Yan, Xin Shen, Rixing Wang, Zhiqian Luo, Xiaotong Han, Yong Gan, Chuanzhu Lv

Published in: Human Resources for Health | Issue 1/2021

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Abstract

Background

Adverse consequences of physician turnover include financial losses, reduced patient satisfaction, and organizational instability. However, no study has reported the prevalence among emergency physicians. This study explore the rate and influencing factors of this community, which could provide a reference for preventing the loss of emergency physicians.

Methods

A nationally representative cross-sectional survey of 15,243 emergency physicians was conducted in 31 provinces across China between July and September 2019. Multivariable logistic regression analysis was performed to identify predictors of turnover intention.

Results

There were 49.75% of emergency physicians having turnover intention. Logistic regression analysis model showed that emergency physicians who were male (OR = 0.87) and older [> 37 and ≤ 43 (OR = 0.78) or > 43 (OR = 0.64)], worked in eastern China (OR = 0.88) and higher level of hospital [two-grade level (OR = 0.71) or three-grade level (OR = 0.56)], and had high (OR = 0.75) or middle (OR = 0.81) level income were not more likely to have less turnover intention, while those who had higher education level [bachelor degree (OR = 1.55) or master degree or higher (OR = 1.63)], long work tenure [> 3 and ≤ 6 (OR = 1.29) or > 6 and ≤ 11 (OR = 1.41) or > 11 (OR = 1.25)], poorer health status [fair (OR = 1.55) or poor (OR = 2.12)] and sleep quality [fair (OR = 1.16) or poor (OR = 1.43)], history of coronary heart disease (OR = 1.29), depression (OR = 2.77) and experienced the shift work (OR = 1.37) and workplace violence (OR = 1.78) were more likely to intend to leave.

Conclusion

Nearly half of emergency physicians in China have turnover intention. Targeted intervening measures should be taken to reduce the turnover intention, so as to avoid the shortage of physicians and thus hinder the supply of emergency medical services.
Literature
1.
Nancarrow S, Bradbury J, Pit SW, Ariss S. Intention to stay and intention to leave: are they two sides of the same coin? A cross-sectional structural equation modelling study among health and social care workers. J Occup Health. 2014;56(4):292–300.PubMedCrossRef
2.
Hann M, Reeves D, Sibbald B. Relationships between job satisfaction, intentions to leave family practice and actually leaving among family physicians in England. Eur J Public Health. 2011;21(4):499–503.PubMedCrossRef
3.
Schwarzkopf D, Rüddel H, Thomas-Rüddel DO, Felfe J, Poidinger B, Matthäus-Krämer CT, et al. Perceived nonbeneficial treatment of patients, burnout, and intention to leave the job among ICU nurses and junior and senior physicians. Crit Care Med. 2017;45:3.CrossRef
4.
Stone PW, Larson EL, Mooney-Kane C, Smolowitz J, Lin SX, Dick AW. Organizational climate and intensive care unit nurses’ intention to leave*. Crit Care Med. 2006;34:7.CrossRef
5.
6.
Heponiemi T, Kouvonen A, Vänskä J, Halila H, Sinervo T, Kivimäki M, et al. The association of distress and sleeping problems with physicians’ intentions to change profession: the moderating effect of job control. J Occup Health Psychol. 2009;14(4):365–73.PubMedCrossRef
7.
Kankaanranta T, Nummi T, Vainiomäki J, Halila H, Hyppölä H, Isokoski M, et al. The role of job satisfaction, job dissatisfaction and demographic factors on physicians’ intentions to switch work sector from public to private. Health policy. 2007;83(1):50–64.PubMedCrossRef
8.
Masselink LE, Lee SY, Konrad TR. Workplace relational factors and physicians’ intention to withdraw from practice. Health Care Manage Rev. 2008;33(2):178–87.PubMedCrossRef
9.
Sheldon GF, Ricketts TC, Charles A, King J, Fraher EP, Meyer A. The global health workforce shortage: role of surgeons and other providers. Adv Surg. 2008;42:63–85.PubMedCrossRef
10.
11.
12.
Sklar DP. How many doctors will we need? A special issue on the physician workforce. Acad med. 2013;88(12):1785–7.PubMedCrossRef
13.
Buchbinder SB, Wilson M, Melick CF, Powe NR. Estimates of costs of primary care physician turnover. Am J Manag Care. 1999;5(11):1431–8.PubMed
14.
Plomondon ME, Magid DJ, Steiner JF, MaWhinney S, Gifford BD, Shih SC, et al. Primary care provider turnover and quality in managed care organizations. Am J Manag Care. 2007;13(8):465–72.PubMed
15.
Firth-Cozens J, Greenhalgh J. Doctors’ perceptions of the links between stress and lowered clinical care. Soc Sci Med. 1997;44(7):1017–22.PubMedCrossRef
16.
Misra-Hebert AD, Kay R, Stoller JK. A review of physician turnover: rates, causes, and consequences. Am J Med Qual. 2004;19(2):56–66.PubMedCrossRef
17.
Johnston A, Abraham L, Greenslade J, Thom O, Carlstrom E, Wallis M, et al. Review article: Staff perception of the emergency department working environment: Integrative review of the literature. Em Med Australas. 2016;28(1):7–26.CrossRef
18.
Pan C, Pang J, Cheng K, Xu F, Chen Y. Trends and challenges of emergency and acute care in Chinese mainland: 2005–2017. World J Em Med. 2021;12(1):5–11.CrossRef
19.
Song X, Fu W, Liu X, Luo Z, Wang R, Zhou N, et al. Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China. Brain Behav Immun. 2020;88:60–5.PubMedPubMedCentralCrossRef
20.
Zhou H, Li C, Yan Y. The emergency department in China: status and challenges: British Association for Accident and Emergency Medicine; 2014. p. 85–6.
21.
Arora M, Asha S, Chinnappa J, Diwan AD. Review article: burnout in emergency medicine physicians. Emerg Med Australas. 2013;25(6):491–5.PubMedCrossRef
22.
Bragard I, Dupuis G, Fleet R. Quality of work life, burnout, and stress in emergency department physicians: a qualitative review. Eur J Emerg Med. 2015;22(4):227–34.PubMedCrossRef
23.
Jiang F, Zhou H, Rakofsky J, Hu L, Liu T, Wu S, et al. Intention to leave and associated factors among psychiatric nurses in China: a nationwide cross-sectional study. Int J Nurs Stud. 2019;94:159–65.PubMedCrossRef
24.
Shen X, Jiang H, Xu H, Ye J, Lv C, Lu Z, et al. The global prevalence of turnover intention among general practitioners: a systematic review and meta-analysis. Bmc Fam Pract. 2020;21(1):246.PubMedPubMedCentralCrossRef
25.
Jiang H, Ma L, Gao C, Li T, Huang L, Huang W. Satisfaction, burnout and intention to stay of emergency nurses in Shanghai. Emerg Med J. 2017;34(7):448–53.PubMedCrossRef
26.
Wang PX, Wang MZ, Hu GX, Wang ZM. Study on the relationship between workplace violence and work ability among health care professionals in Shangqiu City. Wei Sheng Yan Jiu. 2006;35(4):472–4.PubMed
27.
Cosco TD, Lachance CC, Blodgett JM, Stubbs B, Co M, Veronese N, et al. Latent structure of the Centre for Epidemiologic Studies Depression Scale (CES-D) in older adult populations: a systematic review. Aging Ment Health. 2020;24(5):700–4.PubMedCrossRef
28.
Dozeman E, van Schaik DJ, van Marwijk HW, Stek ML, van der Horst HE, Beekman AT. The center for epidemiological studies depression scale (CES-D) is an adequate screening instrument for depressive and anxiety disorders in a very old population living in residential homes. Int J Geriatr Psychiatry. 2011;26(3):239–46.PubMedCrossRef
29.
Cheng ST, Chan AC. The Center for Epidemiologic Studies Depression Scale in older Chinese: thresholds for long and short forms. Int J Geriatr Psychiatry. 2005;20(5):465–70.PubMedCrossRef
30.
Vilagut G, Forero CG, Barbaglia G, Alonso J. Screening for depression in the general population with the center for epidemiologic studies depression (CES-D): a systematic review with meta-analysis. PLoS ONE. 2016;11(5):e155431.CrossRef
31.
Jiang L, Wang Y, Zhang Y, Li R, Wu H, Li C, et al. The Reliability and Validity of the Center for Epidemiologic Studies Depression Scale (CES-D) for Chinese University Students. Front Psychiatry. 2019;10:315.PubMedPubMedCentralCrossRef
32.
Lu Y, Hu XM, Huang XL, Zhuang XD, Guo P, Feng LF, et al. The relationship between job satisfaction, work stress, work-family conflict, and turnover intention among physicians in Guangdong, China: a cross-sectional study. BMJ Open. 2017;7(5):e14894.CrossRef
33.
Sperlich S, Geyer S. The impact of social and family-related factors on women’s stress experience in household and family work. Int J Public Health. 2015;60(3):375–87.PubMedCrossRef
34.
Wong CA, Spence LH. The influence of frontline manager job strain on burnout, commitment and turnover intention: a cross-sectional study. Int J Nurs Stud. 2015;52(12):1824–33.PubMedCrossRef
35.
Shields MA, Ward M. Improving nurse retention in the National Health Service in England: the impact of job satisfaction on intentions to quit. J Health Econ. 2001;20(5):677–701.PubMedCrossRef
36.
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;11:235.PubMedPubMedCentralCrossRef
37.
Fang P, Liu X, Huang L, Zhang X, Fang Z. Factors that influence the turnover intention of Chinese village doctors based on the investigation results of Xiangyang City in Hubei Province. Int J Equity Health. 2014;13:84.PubMedPubMedCentralCrossRef
38.
Hayes LJ, O’Brien-Pallas L, Duffield C, Shamian J, Buchan J, Hughes F, et al. Nurse turnover: a literature review. Int J Nurs Stud. 2006;43(2):237–63.PubMedCrossRef
39.
Aiken LH, Buchan J, Sochalski J, Nichols B, Powell M. Trends in international nurse migration. Health Aff (Millwood). 2004;23(3):69–77.PubMedCrossRef
40.
Price JL, Mueller CW. Professional turnover: the case of nurses. Health Syst Manage. 1981;15:1–160.PubMed
41.
Colindres CV, Bryce E, Coral-Rosero P, Ramos-Soto RM, Bonilla F, Yassi A. Effect of effort-reward imbalance and burnout on infection control among Ecuadorian nurses. Int Nurs Rev. 2018;65(2):190–9.PubMedCrossRef
42.
Herda DN, Lavelle JJ. The auditor-audit firm relationship and its effect on burnout and turnover intention. Account Horiz. 2012;26(4):707–23.CrossRef
43.
Ki J, Ryu J, Baek J, Huh I, Choi-Kwon S. Association between health problems and turnover intention in shift work nurses: health problem clustering. Int J Env Res Pub He. 2020;17(12):4532.CrossRef
44.
Heponiemi T, Kouvonen A, Vänskä J, Halila H, Sinervo T, Kivimäki M, et al. The association of distress and sleeping problems with physicians’ intentions to change profession: the moderating effect of job control. J Occup Health Psychol. 2009;14(4):365–73.PubMedCrossRef
45.
Zhai L, Zhang H, Zhang D. Sleep duration and depression among adults: a meta-analysis of prospective studies. Depress Anxiety. 2015;32(9):664–70.PubMedCrossRef
46.
Ferri P, Guadi M, Marcheselli L, Balduzzi S, Magnani D, Di Lorenzo R. The impact of shift work on the psychological and physical health of nurses in a general hospital: a comparison between rotating night shifts and day shifts. Risk Manag Healthc Policy. 2016;9:203–11.PubMedPubMedCentralCrossRef
47.
Mata DA, Ramos MA, Bansal N, Khan R, Guille C, Di Angelantonio E, et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015;314(22):2373–83.PubMedPubMedCentralCrossRef
48.
Levis B, Azar M, Thombs BD. Resident physicians with depression or depressive symptoms. JAMA. 2016;315(21):2347.PubMedCrossRef
49.
Rambur B, Palumbo MV, McIntosh B, Mongeon J. A statewide analysis of RNs’ intention to leave their position. Nurs Outlook. 2003;51(4):182–8.PubMedCrossRef
50.
Yin JC, Yang KP. Nursing turnover in Taiwan: a meta-analysis of related factors. Int J Nurs Stud. 2002;39(6):573–81.PubMedCrossRef
51.
Shader K, Broome ME, Broome CD, West ME, Nash M. Factors influencing satisfaction and anticipated turnover for nurses in an academic medical center. J Nurs Adm. 2001;31(4):210–6.PubMedCrossRef
52.
Ramacciati N, Ceccagnoli A, Addey B, Lumini E, Rasero L. Violence towards emergency nurses: a narrative review of theories and frameworks. Int Emerg Nurs. 2018;39:2–12.PubMedCrossRef
53.
Zafar W, Siddiqui E, Ejaz K, Shehzad MU, Khan UR, Jamali S, et al. Health care personnel and workplace violence in the emergency departments of a volatile metropolis: results from Karachi Pakistan. J Emerg Med. 2013;45(5):761–72.PubMedPubMedCentralCrossRef
54.
Groenewold MR, Sarmiento R, Vanoli K, Raudabaugh W, Nowlin S, Gomaa A. Workplace violence injury in 106 US hospitals participating in the Occupational Health Safety Network (OHSN), 2012–2015. Am J Ind Med. 2018;61(2):157–66.PubMedCrossRef
55.
Erickson L, Williams-Evans SA. Attitudes of emergency nurses regarding patient assaults. J Emerg Nurs. 2000;26(3):210–5.PubMedCrossRef
56.
Partridge B, Affleck J. Verbal abuse and physical assault in the emergency department: Rates of violence, perceptions of safety, and attitudes towards security. Australas Emerg Nurs J. 2017;20(3):139–45.PubMedCrossRef
57.
Pinar R, Ucmak F. Verbal and physical violence in emergency departments: a survey of nurses in Istanbul. Turkey J Clin Nurs. 2011;20(3–4):510–7.PubMedCrossRef
58.
Heponiemi T, Kouvonen A, Virtanen M, Vänskä J, Elovainio M. The prospective effects of workplace violence on physicians’ job satisfaction and turnover intentions: the buffering effect of job control. BMC Health Serv Res. 2014;14:19.PubMedPubMedCentralCrossRef
Metadata
Title
The prevalence of turnover intention and influencing factors among emergency physicians: a national observation
Authors
Shijiao Yan
Xin Shen
Rixing Wang
Zhiqian Luo
Xiaotong Han
Yong Gan
Chuanzhu Lv
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2021
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-021-00688-8

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