Health Workforce Crisis: Recruitment and Retention of Skilled Health Workers in the Public Health Sector in Malaysia

Rahim, Razlyn Abdul; Mwanri, Lillian

doi:10.1080/23276665.2012.10779392

Cited by 9 publications

(25 citation statements)

References 20 publications

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“…As for the disadvantages these include: the possibility of over–provision of medical services, the potential harm to the quality of services in the public sector, utilization of public resources in private practice, over–referrals, lack of clear boundaries between the public and private sector, lack of evidence showing improvement of equitable health care delivery, and higher time allocation in private practice while taking advantage of employment benefits in the public sector [2,4,8,16,21]. …”

Section: Resultsmentioning

confidence: 99%

“…Around 72% of the studies (n = 5) highlighted incentives as policy interventions to address physician retention in the public sector [2,4,8,16,21]. Exclusive contracts were identified as being useful for salaried physicians, but noted to be expensive to implement and not be as useful when physicians had incentive contracts [4,21].…”

Section: Resultsmentioning

confidence: 99%

“…As for the disadvantages, these included: costliness in some cases, limited feasibility and it is only considered when limitations are difficult to impose [2,8,16]. For example, Jan et al stated that the cost to the public sector was the main obstacle that prevented the use of incentives as a policy option, particularly in situations where there are resource constraints in the public sector [16].…”

Section: Resultsmentioning

confidence: 99%

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Factors influencing physicians’ choice of workplace: systematic review of drivers of attrition and policy interventions to address them

Koussa¹,

Atun²,

Bowser³

et al. 2016

Journal of Global Health

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ObjectivesThe movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians’ choice of workplace, and policy interventions for retaining physicians in the public sector.MethodsFive literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings.ResultsNineteen articles met the inclusion criteria. Six major themes that affected physicians’ choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions.ConclusionWhile factors affecting physicians’ choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross–country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public sector.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Factors influencing physicians’ choice of workplace: systematic review of drivers of attrition and policy interventions to address them

Koussa¹,

Atun²,

Bowser³

et al. 2016

Journal of Global Health

View full text Add to dashboard Cite

show abstract

“…However, according to a 2015 estimation, at least 4.8 billion of the world's population do not have access to surgery services, and most of this inaccessibility occurs in low-to middle-income countries (4). The current shortage of surgery specialists will be exacerbated in the near future due to changes in world demography in aging and noncommunicable diseases, the prevalence of chronic disease and workforce flow, especially in mid-dle-to high-income countries (5,6). One of the workforce flows which affects specialist supply is the phenomenon of dual practice (DP), defined as working simultaneously in the public and the private sector (7,8).…”

Section: Introductionmentioning

confidence: 99%

Effect of dual practice on service delivery time by surgeons in the Islamic Republic of Iran: multi-level analysis of a national survey, 2016

Bayat

Shokri

Khalilnezhad

et al. 2018

East Mediterr Health J

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Background: One of the work patterns which affects the supply of specialists is the phenomenon of dual practice (DP), i.e., working simultaneously in the public and private sectors. Uncontrolled DP in the surgery health workforce can have adverse effects on access to surgeons, efficiency, effectiveness and quality of surgery services. Aims: The aim of this article is to examine the impact of DP on service delivery time by surgeons. Methods: We used a prestructured form to collect data on surgery specialists in all 925 Iranian hospitals. National medical ID codes, council ID codes, first name, surname and father's name were used for data matching. Multilevel linear regression was used to assess the association between DP and study variables, which were recruitment type, faculty status, experience, sex and age. Results: The 4642 surgery specialists in this study, representing 31.08% of the total number of surgeons identified, spent mean 1.09 (standard deviation 0.33) hours full-time equivalent (FTE) on health care service delivery. Specialists with DP had long service delivery time (β = 0.427). Female specialists (β =-0.049) and full-time specialists (β =-0.082) spent less time on health care service delivery. Permanent specialists had higher FTE (P < 0.001) and as the population increases, FTE increases (P < 0.05). Conclusions: Although DP had a direct impact on surgeons' working hours, it seems that a greater share of the difference in working time was used in the private sector services, leading to poor access to surgery services in the public sector. Therefore, it is necessary to develop a systems approach to regulate DP.

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“…Physicians work in both public and private hospitals and clinics to raise their income in most countries (5). Other factors that attract physicians to DP include greater flexibility of private practice, more opportunities for patient contact and more self-management (6,7).…”

Section: Introductionmentioning

confidence: 99%

Factors influencing medical specialists’ dual practice in the Islamic Republic of Iran

Bayat

Shokri

Khodadost

et al. 2018

East Mediterr Health J

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Background: Dual practice (DP) is performing several different jobs at the same time and has effects on healthcare services delivery. Aims: To identify the causes of medical specialists' tendency towards DP in the Islamic Republic of Iran. Methods: We used a qualitative approach to identify the factors affecting DP in medical specialists in 2016. We used a purposive and outlier sampling method to conduct semistructured deep interviews with 14 key informants. The data analysis was performed simultaneously with data collection using thematic content analysis by MAXQDA (version 10.0). Interviews continued up to data saturation. The quality of the study was ensured by addressing the criteria of Guba and Lincoln. Results: The results of the interviews showed six themes and 16 subthemes for specialists' propensity to DP. Major themes included financial incentives, cultural attitudes about professional identity of physicians, experience and academic level of specialists, controlling approaches in the public sector, available infrastructure for responding to the population needs in the public sector, and regional characteristics of health service locations. Conclusions: Medical specialists' DP is a multidimensional issue, influenced by different factors such as financial incentives, cultural attitudes and available infrastructure. Considering the capacities and conditions of each country, control and management of this phenomenon require regulatory and incentive mechanisms, which in the long term can modify private and public sector differences and increase the willingness of doctors to work in the public sector.

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Health Workforce Crisis: Recruitment and Retention of Skilled Health Workers in the Public Health Sector in Malaysia

Cited by 9 publications

References 20 publications

Factors influencing physicians’ choice of workplace: systematic review of drivers of attrition and policy interventions to address them

Factors influencing physicians’ choice of workplace: systematic review of drivers of attrition and policy interventions to address them

Effect of dual practice on service delivery time by surgeons in the Islamic Republic of Iran: multi-level analysis of a national survey, 2016

Factors influencing medical specialists’ dual practice in the Islamic Republic of Iran

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