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印度尼西亚偏远地区医生和牙医的留用:一项离散选择实验

Retention of Doctors and Dentists to Serve in Remote Areas in Indonesia: A Discrete Choice Experiment.

作者信息

Kurniati Anna, Efendi Ferry, Ismawiningsih Ismawiningsih, Mulyani Nila, Zakaria Zakaria, Ambarwati Retno, Prasetyo Hutomo Tuhu, Muljandari Endro, Damayanti Irni, Noor Arif Yustian Maulana, McKenna Lisa, Nurlinawati Iin

机构信息

Directorate of Health Workforce Deployment, Directorate General of Health Workforce, Ministry of Health, Jakarta, Indonesia.

Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.

出版信息

J Multidiscip Healthc. 2024 May 9;17:2215-2225. doi: 10.2147/JMDH.S459158. eCollection 2024.

Abstract

INTRODUCTION

Retaining doctors and dentists in remote areas of Indonesia remains a national priority of the Indonesian government. The purpose of this study was to analyze the interventions for retention of doctors and dentists in remote areas using the discrete choice experiment (DCE) approach.

MATERIALS AND METHODS

A DCE was conducted to investigate preferences of doctors and dentists for retention in remote areas. This research was conducted in 78 primary healthcare settings across 15 provinces in Indonesia. The conditional logit model was used to explore stated preferences for each attribute.

RESULTS

The total number of respondents was 158, including 113 doctors and 45 dentists. In general, doctors placed the highest preference on getting priority for government scholarships to facilitate retention in remote areas (OR=5.65, p<0.001). Specifically, dentists preferred security guarantees from local government (OR = 4.87, p<0.001). Both groups valued having an official residence (OR=3.6, p<0.001) as a factor for retention in remote areas.

CONCLUSION

Scholarship, security guarantees, housing facilities, and medical facilities were the most considered factors for retaining doctors and dentists in a remote area. This study confirms the importance of a combination of interventions in maintaining doctors and dentists in remote areas. Policy options in the form of non-financial and financial intervention packages can be combined to improve their retention.

摘要

引言

在印度尼西亚偏远地区留住医生和牙医仍是印度尼西亚政府的一项国家优先事项。本研究的目的是使用离散选择实验(DCE)方法分析在偏远地区留住医生和牙医的干预措施。

材料与方法

进行了一项DCE,以调查医生和牙医对留在偏远地区的偏好。这项研究在印度尼西亚15个省份的78个初级卫生保健机构中进行。使用条件logit模型来探索对每个属性的陈述偏好。

结果

受访者总数为158人,其中包括113名医生和45名牙医。总体而言,医生对获得政府奖学金以促进留在偏远地区的优先级最为看重(OR=5.65,p<0.001)。具体而言,牙医更倾向于获得当地政府的安全保障(OR = 4.87,p<0.001)。两组都将拥有官方住所(OR=3.6,p<0.001)视为留在偏远地区的一个因素。

结论

奖学金、安全保障、住房设施和医疗设施是在偏远地区留住医生和牙医时最受考虑的因素。本研究证实了多种干预措施相结合对于在偏远地区留住医生和牙医的重要性。可以将非财务和财务干预措施形式的政策选项结合起来,以提高他们的留任意愿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8cb/11090117/00a622bb7363/JMDH-17-2215-g0001.jpg

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