Exploring healthcare provider retention in a rural and frontier community in Northern Idaho.
Frontier
NCAQ
Retention
Rural
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
27 Mar 2024
27 Mar 2024
Historique:
received:
21
12
2023
accepted:
29
02
2024
medline:
28
3
2024
pubmed:
28
3
2024
entrez:
28
3
2024
Statut:
epublish
Résumé
A shortage of healthcare providers, particularly in primary care and mental health, exists in the predominately rural state of Idaho. There are also barriers to retaining healthcare providers to work in rural and remote communities. Limited research using U.S. samples has explored factors that may affect the retention of healthcare providers in rural areas. Additionally, due to differences between communities, it is important to conduct community-level investigations to better understand how these factors may affect retention in rural areas. Therefore, the purpose of this study was to explore factors affecting healthcare provider retention in a rural community in Northern Idaho. A modified version of the Nursing Community Apgar Questionnaire (NCAQ) was completed by 30 healthcare providers in a rural and frontier community in Northern Idaho to assess factors influencing healthcare provider retention. Factors were classified into classes including geographic, economic, scope of practice, medical support, and facility and community support classes. Retention factors were assessed on their perceived importance to retention as well as whether they were perceived as an advantage or challenge to retention based on Likert scales. A "Community Apgar" score was also created by combining the importance and advantage/challenge factors. Overall, items in the medical support group had the highest importance of any other class and included factors such as nursing workforce. Additionally, the facility and community support class, which included factors such as televideo support, was rated the highest advantage class and had the highest Apgar score, indicating it contained the factor that healthcare providers identified as the most important advantage (i.e., medical reference resources). Our study identified multiple factors that healthcare providers deemed as important advantages or disadvantages to retaining healthcare providers in rural areas. Overall, facility and community support factors were found to have the highest advantage in the retention of rural providers. Rural healthcare organizations looking to increase healthcare provider retention should target retention efforts towards these factors. Additional research should also be conducted on other rural samples across the U.S. to make comparisons of findings.
Sections du résumé
BACKGROUND
BACKGROUND
A shortage of healthcare providers, particularly in primary care and mental health, exists in the predominately rural state of Idaho. There are also barriers to retaining healthcare providers to work in rural and remote communities. Limited research using U.S. samples has explored factors that may affect the retention of healthcare providers in rural areas. Additionally, due to differences between communities, it is important to conduct community-level investigations to better understand how these factors may affect retention in rural areas. Therefore, the purpose of this study was to explore factors affecting healthcare provider retention in a rural community in Northern Idaho.
METHODS
METHODS
A modified version of the Nursing Community Apgar Questionnaire (NCAQ) was completed by 30 healthcare providers in a rural and frontier community in Northern Idaho to assess factors influencing healthcare provider retention. Factors were classified into classes including geographic, economic, scope of practice, medical support, and facility and community support classes. Retention factors were assessed on their perceived importance to retention as well as whether they were perceived as an advantage or challenge to retention based on Likert scales. A "Community Apgar" score was also created by combining the importance and advantage/challenge factors.
RESULTS
RESULTS
Overall, items in the medical support group had the highest importance of any other class and included factors such as nursing workforce. Additionally, the facility and community support class, which included factors such as televideo support, was rated the highest advantage class and had the highest Apgar score, indicating it contained the factor that healthcare providers identified as the most important advantage (i.e., medical reference resources).
CONCLUSION
CONCLUSIONS
Our study identified multiple factors that healthcare providers deemed as important advantages or disadvantages to retaining healthcare providers in rural areas. Overall, facility and community support factors were found to have the highest advantage in the retention of rural providers. Rural healthcare organizations looking to increase healthcare provider retention should target retention efforts towards these factors. Additional research should also be conducted on other rural samples across the U.S. to make comparisons of findings.
Identifiants
pubmed: 38539177
doi: 10.1186/s12913-024-10807-5
pii: 10.1186/s12913-024-10807-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
381Subventions
Organisme : Avista Foundation
ID : NA
Organisme : Avista Foundation
ID : NA
Organisme : Innovia Foundation
ID : NA
Organisme : Innovia Foundation
ID : NA
Informations de copyright
© 2024. The Author(s).
Références
U.S. Census Bureau. New Census Data Show Differences Between Urban and Rural Populations 2022. https://www.census.gov/newsroom/press-releases/2016/cb16-210.html . Accessed 10 March 2023.
Moy E, Garcia MC, Bastian B, Rossen LM, Ingram DD, Faul M, et al. Leading causes of death in Nonmetropolitan and Metropolitan areas- United States, 1999–2014. Morbidity Mortal Wkly Rep Surveilleance Summary. 2017;66(1):1–8.
Agency for Healthcare Research and Quality. Primary Care Workforce Facts and Stats No. 3. 2010. https://www.ahrq.gov/research/findings/factsheets/primary/pcwork3/index.html . Accessed 12 April 2023.
Wolkenhauer S, July. The future of Rural Idaho.: 2018. https://www.labor.idaho.gov/dnn/Portals/0/Publications/Future_of_Rural_Idaho_FINAL.pdf . Accessed 13 April 2023.
Arispe IE, Gindi RM, Madans JH, Health, United States. 2019. https://stacks.cdc.gov/view/cdc/100685 . Accessed 13 April 2023.
Association of American Medical Colleges. State Physician Workforce Data Report Washington, DC; 2021.
Idaho Department of Health and Welfare. Rural and Underserved Areas 2022. https://healthandwelfare.idaho.gov/providers/rural-health-and-underserved-areas/rural-health-and-underserved-areas Accessed 20 April 2023.
Idaho Legislature Office of Performance Evaluations. Sustainability of Idaho’s Direct Care Workforce. 2023. https://legislature.idaho.gov/wp-content/uploads/OPE/Reports/r2202.pdf .
World Health Organization. Building better together: roadmap to guide implementation of the Global Strategic Directions for Nursing and Midwifery in the WHO European Region. Copenhagen: World Health Organization Regional Office for Europe; 2021. Contract No.: WHO/EURO:2021-4464-44227-62471.
Watanabe-Galloway S, Madison L, Watkins KL, Nguyen AT, Chen LW. Recruitment and retention of mental health care providers in rural Nebraska: perceptions of providers and administrators. Rural Remote Health. 2015;15(4):3392.
pubmed: 26567807
King J, Geiger L, Silberman P, Slifkin R. State profiles of Medicaid and SCHIP in Rural and Urban Areas. North Carolina Rural Health Research and Policy Analysis Center; 2007.
Williams MA. Rural professional isolation: an integrative review. Online J Rural Nurs Health Care. 2012;12:3–10.
doi: 10.14574/ojrnhc.v12i2.51
Incitti F, Rourke J, Rourke LL, Kennard M. Rural women family physicians. Are they unique? Can Fam Physician. 2003;49:320–7.
pubmed: 12675545
pmcid: 2214194
Miller KK. The clinical, professional, and social challenges of practicing rural medicine. Am Med Association J Ethics. 2011;13(5):271–2.
Myroniuk L, Adamiak P, Bajaj S, Myhre DL. Recruitment and retention of physicians in rural Alberta: the spousal perspective. Rural Remote Health. 2016;16(1):3620.
pubmed: 26859245
Mohammadiaghdam N, Doshmangir L, Babaie J, Khabiri R, Ponnet K. Determining factors in the retention of physicians in rural and underdeveloped areas: a systematic review. BMC Fam Pract. 2020;21(1):216.
doi: 10.1186/s12875-020-01279-7
pubmed: 33097002
pmcid: 7585284
Cosgrave C, Malatzky C, Gillespie J. Social determinants of rural health workforce retention: a scoping review. Int J Environ Res Public Health. 2019;16(3).
Sargeant J, Allen M, Langille D. Physician perceptions of the effect of telemedicine on rural retention and recruitment. J Telemed Telecare. 2004;10(2):89–93.
doi: 10.1258/135763304773391521
pubmed: 15068644
Prengaman M, Terry D, Schmitz D, Baker E. The nursing community Apgar Questionnaire in Rural Australia: an evidence based approach to recruiting and retaining nurses. Online J Rural Nurs Health Care. 2017;17:148–71.
doi: 10.14574/ojrnhc.v17i2.459
Terry DR, Baker E, Schmitz DF. Community assets and capabilities to recruit and retain GPs: the Community Apgar Questionnaire in rural Victoria. Rural Remote Health. 2016;16(4):1–10.
Witt J. Physician recruitment and retention in Manitoba: results from a survey of physicians’ preferences for rural jobs. Can J Rural Med. 2017;22(2):43–53.
pubmed: 28441127
Simmons D, Bolitho LE, Phelps GJ, Ziffer R, Disher GJ. Dispelling the myths about rural consultant physician practice: the victorian Physicians Survey. Med J Aust. 2002;176(10):477–81.
doi: 10.5694/j.1326-5377.2002.tb04519.x
pubmed: 12065011
Hays R, Wynd S, Veitch C, Crossland L, GETTING, THE BALANCE RIGHT? GPS WHO CHOSE TO STAY IN RURAL PRACTICE. Aust J Rural Health. 2003;11(4):193–8.
doi: 10.1111/j.1440-1584.2003.tb00535.x
pubmed: 14641232
Mandal A, Phillips S. To stay or not to stay: the role of sense of belonging in the retention of physicians in rural areas. Int J Circumpolar Health. 2022;81(1):2076977.
doi: 10.1080/22423982.2022.2076977
pubmed: 35575172
pmcid: 9116258
Wieland L, Ayton J, Abernethy G. Retention of General practitioners in remote areas of Canada and Australia: a meta-aggregation of qualitative research. Aust J Rural Health. 2021;29(5):656–69.
doi: 10.1111/ajr.12762
pubmed: 34496106
Rabinowitz HK, Diamond JJ, Markham FW, Santana AJ. Retention of rural family physicians after 20–25 years: outcomes of a comprehensive medical school rural program. J Am Board Fam Med. 2013;26(1):24–7.
doi: 10.3122/jabfm.2013.01.120122
pubmed: 23288277
Cogbill TH, Bintz M. Rural general surgery: a 38-Year experience with a Regional Network established by an Integrated Health System in the Midwestern United States. J Am Coll Surg. 2017;225(1):115–23.
doi: 10.1016/j.jamcollsurg.2017.02.010
pubmed: 28242434
Abelsen B, Strasser R, Heaney D, Berggren P, Sigurðsson S, Brandstorp H, et al. Plan, recruit, retain: a framework for local healthcare organizations to achieve a stable remote rural workforce. Hum Resourses Health. 2020;18(1):63.
doi: 10.1186/s12960-020-00502-x
Prengaman MP, Bigbee JL, Baker E, Schmitz DF. Development of the nursing community Apgar Questionnaire (NCAQ): a rural nurse recruitment and retention tool. Rural Remote Health. 2014;14:2633.
pubmed: 24588333
Reed AJ, Schmitz D, Baker E, Girvan J, McDonald T. Assessment of factors for recruiting and retaining medical students to rural communities using the Community Apgar Questionnaire. Fam Med. 2017;49(2):132–6.
pubmed: 28218939
Idaho Nursing Workforce Center. The Idaho nursing workforce: 2022 report. Boise, Idaho; 2022.
Jones PD, Seoane L, Deichmann R Jr., Kantrow C. Differences and similarities in the practice of medicine between Australia and the United States of America: challenges and opportunities for the university of queensland and the ochsner clinical school. Ochsner J. 2011;11(3):253–8.
pubmed: 21960759
pmcid: 3179196
Grimm P. Social desirability bias. Wiley international encyclopedia of marketing. 2010.