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Retaining rural doctors: Doctors' preferences for rural medical workforce incentives

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  • Li, Jinhu
  • Scott, Anthony
  • McGrail, Matthew
  • Humphreys, John
  • Witt, Julia

Abstract

Many governments have implemented incentive programs to improve the retention of doctors in rural areas despite a lack of evidence of their effectiveness. This study examines rural general practitioners' (GPs') preferences for different types of retention incentive policies using a discrete choice experiment (DCE). In 2009, the DCE was administered to a group of 1720 rural GPs as part of the “Medicine in Australia: Balancing Employment and Life (MABEL)” study. We estimate both a mixed logit model and a generalized multinomial logit model to account for different types of unobserved differences in GPs' preferences. Our results indicate that increased level of locum relief incentive, retention payments and rural skills loading leads to an increase in the probability of attracting GPs to stay in rural practice. The locum relief incentive is ranked as the most effective, followed by the retention payments and rural skills loading payments. These findings are important in helping to tailor retention policies to those that are most effective.

Suggested Citation

  • Li, Jinhu & Scott, Anthony & McGrail, Matthew & Humphreys, John & Witt, Julia, 2014. "Retaining rural doctors: Doctors' preferences for rural medical workforce incentives," Social Science & Medicine, Elsevier, vol. 121(C), pages 56-64.
  • Handle: RePEc:eee:socmed:v:121:y:2014:i:c:p:56-64
    DOI: 10.1016/j.socscimed.2014.09.053
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    References listed on IDEAS

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    1. Julie Riise Kolstad, 2011. "How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 196-211, February.
    2. Boxall, Peter C. & Adamowicz, Wiktor L. & Moon, Amanda, 2009. "Complexity in choice experiments: choice of the status quo alternative and implications for welfare measurement," Australian Journal of Agricultural and Resource Economics, Australian Agricultural and Resource Economics Society, vol. 53(4), pages 1-17.
    3. Emily Lancsar & Jordan Louviere, 2008. "Conducting Discrete Choice Experiments to Inform Healthcare Decision Making," PharmacoEconomics, Springer, vol. 26(8), pages 661-677, August.
    4. Mandy Ryan & Diane Skåtun, 2004. "Modelling non‐demanders in choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 397-402, April.
    5. Flynn, Terry Nicholas & Louviere, Jordan J. & Peters, Tim J. & Coast, Joanna, 2010. "Using discrete choice experiments to understand preferences for quality of life. Variance-scale heterogeneity matters," Social Science & Medicine, Elsevier, vol. 70(12), pages 1957-1965, June.
    6. Lagarde, Mylene & Blaauw, Duane & Cairns, John, 2012. "Cost-effectiveness analysis of human resources policy interventions to address the shortage of nurses in rural South Africa," Social Science & Medicine, Elsevier, vol. 75(5), pages 801-806.
    7. Scott, Anthony & Witt, Julia & Humphreys, John & Joyce, Catherine & Kalb, Guyonne & Jeon, Sung-Hee & McGrail, Matthew, 2013. "Getting doctors into the bush: General Practitioners' preferences for rural location," Social Science & Medicine, Elsevier, vol. 96(C), pages 33-44.
    8. Chomitz, Kenneth M. & Setiadi, Gunawan & Azwar, Azrul & Ismail, Nusye & Widiyarti, 1998. "What do doctors want? developing incentives for doctors to serve in Indonesia's rural and remote areas," Policy Research Working Paper Series 1888, The World Bank.
    9. Hole, Arne Risa, 2008. "Modelling heterogeneity in patients' preferences for the attributes of a general practitioner appointment," Journal of Health Economics, Elsevier, vol. 27(4), pages 1078-1094, July.
    10. Arne Hole & Julie Kolstad, 2012. "Mixed logit estimation of willingness to pay distributions: a comparison of models in preference and WTP space using data from a health-related choice experiment," Empirical Economics, Springer, vol. 42(2), pages 445-469, April.
    11. Denzil G. Fiebig & Michael P. Keane & Jordan Louviere & Nada Wasi, 2010. "The Generalized Multinomial Logit Model: Accounting for Scale and Coefficient Heterogeneity," Marketing Science, INFORMS, vol. 29(3), pages 393-421, 05-06.
    12. Hess, Stephane & Rose, John M. & Hensher, David A., 2008. "Asymmetric preference formation in willingness to pay estimates in discrete choice models," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 44(5), pages 847-863, September.
    13. Till Bärnighausen & David E. Bloom, 2008. "Financial incentives for return of service in underserved areas: a systematic review," PGDA Working Papers 3608, Program on the Global Demography of Aging.
    14. Hall, Jane & Fiebig, Denzil G. & King, Madeleine T. & Hossain, Ishrat & Louviere, Jordan J., 2006. "What influences participation in genetic carrier testing?: Results from a discrete choice experiment," Journal of Health Economics, Elsevier, vol. 25(3), pages 520-537, May.
    15. Michael Keane & Nada Wasi, 2013. "Comparing Alternative Models Of Heterogeneity In Consumer Choice Behavior," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 28(6), pages 1018-1045, September.
    16. Fredrik Carlsson & Peter Martinsson, 2003. "Design techniques for stated preference methods in health economics," Health Economics, John Wiley & Sons, Ltd., vol. 12(4), pages 281-294, April.
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    5. Bunmi S Malau-Aduli & Amy M Smith & Louise Young & Tarun Sen Gupta & Richard Hays, 2020. "To stay or go? Unpacking the decision-making process and coping strategies of International Medical Graduates practising in rural, remote, and regional Queensland, Australia," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-20, June.
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    8. Swami, Megha & Scott, Anthony, 2021. "Impact of rural workforce incentives on access to GP services in underserved areas: Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 281(C).
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