Department of Health Policy& Management, Tabriz Health Services Management Research Center, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran.
Social Determinants of Health Services Research, Health Management and safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Fam Pract. 2020 Oct 23;21(1):216. doi: 10.1186/s12875-020-01279-7.
Imbalance in distribution of Health Care Workers (HCWs) in a country is a global challenge. Almost all of the rural and underdeveloped areas are struggling with the shortage of HCWs, especially physicians. Therefore, this study aimed to identify factors governing the retention of physicians in rural and underdeveloped areas.
International databases including Scopus, PubMed, Web of Science, Proquest, and Embase were searched using Mesh terms in order to find peer-reviewed journal articles addressing physicians' retention factors in rural and underdeveloped areas. The records were screened, and any duplicate results were removed. The quality of the studies was assessed according to the Critical Appraisal Skills Program developed for different types of studies. Then, through content analysis, the related factors were identified from finally selected papers, coded, and categorized.
The initial search resulted in 2312 relevant articles. On the basis of specific selection criteria, 35 full-text articles were finally reviewed.. The major affecting factors in physicians' retention in rural and underdeveloped regions were classified into the following six categories: 1) financial; 2) career and professional; 3) working conditions; 4) personal; 5) cultural; and 6) living conditions factors.
There is a complex interplay of factors governing physicians' retention in rural and underdeveloped areas. If health organizations are concerned with physicians' retention in deprived areas, they should take into account these main factors. Moreover, they should develop policies and strategies to attract and retain physicians in rural and underdeveloped areas.
卫生保健工作者（HCWs）在国家间分布不均是一个全球性挑战。几乎所有的农村和欠发达地区都在努力应对 HCWs 短缺的问题，尤其是医生。因此，本研究旨在确定影响农村和欠发达地区医生留用的因素。
使用 Scopus、PubMed、Web of Science、Proquest 和 Embase 等国际数据库，使用Mesh 术语搜索同行评议的期刊文章，以确定农村和欠发达地区医生留用的因素。筛选记录并删除任何重复结果。根据针对不同类型研究制定的批判性评估技能计划评估研究质量。然后，通过内容分析，从最终选择的论文中识别出相关因素，对其进行编码和分类。
最初的搜索产生了 2312 篇相关文章。根据具体的选择标准，最终对 35 篇全文文章进行了回顾。影响农村和欠发达地区医生留用的主要因素可分为以下六类：1）财务；2）职业和专业；3）工作条件；4）个人；5）文化；6）生活条件因素。
影响农村和欠发达地区医生留用的因素错综复杂。如果卫生组织关注贫困地区医生的留用问题，就应该考虑这些主要因素。此外，他们应该制定政策和策略，以吸引和留住农村和欠发达地区的医生。
