Elham Ehsani-Chimeh1, Reza Majdzadeh2, Sajad Delavari3, Masoumeh Najafi Gharebelagh4, Satar Rezaei5, Enayatollah Homaie Rad6. 1. National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 2. Knowledge Utilization Research Center, Community-Based Participatory-Research Center and School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 3. School of Health Management and Informatics, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran. 4. School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 5. Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Islamic Republic of Iran. 6. Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran.
Abstract
BACKGROUND: Migration of physicians from less developed countries to affluent ones has become as one of the major concerns of human resource policy-makers. This leads to problems such as inequity in the distribution of physicians, lack of physicians in less developed areas, as well as an excess of the health workforce in developed environs. Thus, policy-makers aim to increase retention of physicians in their places of origin. AIMS: This study aimed to find those effective factors for the retention of physicians in the Islamic Republic of Iran. METHODS: 30 569 records of public sector physicians in 2016 were gathered from the Ministry of Health and Medical Education database, and the retention rate of each province was calculated. Geographic information system (GIS) was used to show retention in each province, and linear and logistic regression analysis were used to determine the effective factors for physicians' retention in the country. RESULTS: There was a significant relationship between per capita gross domestic product of each province and its retention rate of physicians (OR = 1.56), retention rate of family physicians (OR = 7.38), and retention rate of specialists (OR = 1.59). In addition, relationships were significant for the human development index (all physicians [OR = 1.22], family physicians [OR = 2.36], and specialists [OR = 1.23]). Married physicians, higher paid physicians, and those who worked in headquarters and clinics showed greater willingness to stay in their area of origin. CONCLUSIONS: Physicians' retention rate is dependent on both macro and microlevel factors.
BACKGROUND: Migration of physicians from less developed countries to affluent ones has become as one of the major concerns of human resource policy-makers. This leads to problems such as inequity in the distribution of physicians, lack of physicians in less developed areas, as well as an excess of the health workforce in developed environs. Thus, policy-makers aim to increase retention of physicians in their places of origin. AIMS: This study aimed to find those effective factors for the retention of physicians in the Islamic Republic of Iran. METHODS: 30 569 records of public sector physicians in 2016 were gathered from the Ministry of Health and Medical Education database, and the retention rate of each province was calculated. Geographic information system (GIS) was used to show retention in each province, and linear and logistic regression analysis were used to determine the effective factors for physicians' retention in the country. RESULTS: There was a significant relationship between per capita gross domestic product of each province and its retention rate of physicians (OR = 1.56), retention rate of family physicians (OR = 7.38), and retention rate of specialists (OR = 1.59). In addition, relationships were significant for the human development index (all physicians [OR = 1.22], family physicians [OR = 2.36], and specialists [OR = 1.23]). Married physicians, higher paid physicians, and those who worked in headquarters and clinics showed greater willingness to stay in their area of origin. CONCLUSIONS: Physicians' retention rate is dependent on both macro and microlevel factors.