The global prevalence of turnover intention among general practitioners: a systematic review and meta-analysis

Abstract

Background General practitioners (GPs) are the foundation of any primary healthcare system. Their quality and quantity are directly associated with the effectiveness and quality of the health services of a nation. GPs’ shortage and turnover have become an important issue in developed and developing countries. An accurate estimate of turnover intention prevalence among GPs would have important health policy implications, but the overall prevalence is unknown. We aimed to summarize the global prevalence of turnover intention and associated factors among GPs. Methods We systematically reviewed the PubMed, Embase, Web of Science and China National Knowledge Infrastructure (CNKI) databases from their inception up to May 2020, as well as the reference lists of all included studies. We included observational studies that reported data on turnover intention or their prevalence rate among GPs could be calculated based on the information provided. The prevalence rate of the turnover intentions was estimated using a random-effects meta-analysis. The heterogeneity was evaluated using I2 statistic. Differences by study level characteristics were estimated via subgroup analysis and meta-regression. Results A total of 25 cross-sectional studies were included (a total of 27,285 participants). The prevalence of turnover intention was 0.47 (95% CI: 0.39–0.55). Those having a lower level of salary (OR = 1.38, 95% CI: 1.13–1.63) and job satisfaction (OR = 1.35, 95% CI: 1.12–1.70) or having lower level of morale (OR = 2.68, 95% CI: 1.56–3.80) had a higher intention. In contrast, GPs with a lower level of professional title had a lower turnover intention (OR = 0.81, 95% CI: 0.65–0.98). Conclusions In this systematic review, approximately half of the GPs had the intention to leave their current posts worldwide. The factors associated with turnover intention were higher professional title, lower income level, lower job satisfaction and lower morale.

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

“…We found that nearly half (49.75%) of emergency physicians had turnover intention. Compared to previous studies of psychiatrists (20%) [ 23 ], general practitioners (47%) [ 24 ], and emergency department nurses (23%) [ 25 ], emergency physicians showed higher levels of turnover intention, which indicated that fully attention should be paid to this community. In addition, we identified a number of representative factors that clearly correlate with the increasing of turnover intention among emergency physicians, which could provide references for targeted measures.…”

“…However, it has not been reported whether emergency physicians have higher turnover intentions. Previous studies on turnover intention mostly focused on psychiatrists [ 23 ], general practitioners [ 24 ], emergency department nurses [ 25 ] and other groups. Therefore, the purpose of this study was to explore the prevalence of turnover intentions (including switching departments and turnover) of emergency physicians and influencing factors, which could provide a reference for global health-care policy makers and researchers to solve the shortage of physicians.…”

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

“…This difference was possibly related to social environment, the level of economic development and the working environment among various countries. Also, due to the heavy workloads and working without adequate rest that the rate of the turnover intention among physicians in emergency department was much higher than that of radiologists (33.3%), general practitioners (47%) and physicians in intensive care (26%) [ 24 - 26 ].…”

Rates of turnover among general practitioners: a retrospective study of all English general practices between 2007 and 2019

“…However, recent data have shown that the GP workforce in England is going through a major crisis, 1 reflected in increasing rates of early retirement and intentions to reduce hours of working or leave their practice in the near future. 2 Despite this being a common problem for other European countries 3 and globally, 4 it seems to be particularly serious for the UK. 3 5 According to an international survey of GPs from 2015, approximately 30% of GPs want to leave their profession within 5 years.…”

“…Low retention or decreasing retention levels over time and high turnover rates are major issues for NHS primary care. High GP turnover is a concern for several reasons: it may be associated with practices experiencing recurring problems with recruitment and retention 10 ; it may affect the ability to deliver primary care services 4 and undermine continuity of care which in turn may affect the quality of patient care. For instance, healthcare received from multiple GPs can lead to conflicting therapeutic treatments and fragmented care.…”