Directorate General of Health Workforce, Ministry of Health, Jakarta, Indonesia.
School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
PLoS One. 2024 Aug 15;19(8):e0308225. doi: 10.1371/journal.pone.0308225. eCollection 2024.
The equitable distribution of medical specialists in Indonesia's remote areas remains a challenge. This study investigated the preferences of medical specialists regarding retention programs aimed at addressing this issue.
A Discrete Choice Experiment (DCE) was utilized to collect stated preferences from 341 medical specialist working in district general hospitals across 10 Indonesian provinces. The DCE retention questionnaire focused on eight key characteristics: location, medical facilities, net income, continuing professional development program, security, length of commitment, source of incentives, and caseload.
The study found that the most influential factors for retention in remote areas were security guarantees from the local government (OR = 6.11), fully funded continuing professional development programs (OR = 2.84), and access to advanced medical facilities (OR = 2.35).
The findings indicate that a comprehensive intervention package, with a particular emphasis on security provisions, is necessary to retain medical specialists in remote areas. Financial incentives are also recommended to improve retention. However, it is crucial to acknowledge that no single intervention will suffice, as the factors influencing specialist retention in remote areas of Indonesia are complex and multifaceted.
印度尼西亚偏远地区医疗专家的公平分配仍然是一个挑战。本研究调查了医疗专家对旨在解决这一问题的留用计划的偏好。
利用离散选择实验（DCE）从印尼 10 个省的 341 名在地区综合医院工作的医疗专家那里收集了他们的陈述偏好。DCE 留用调查问卷的重点是八个关键特征：地点、医疗设施、净收入、继续教育发展计划、安全保障、服务承诺期限、激励措施来源和病例量。
研究发现，在偏远地区留住医疗专家的最主要因素是当地政府的安全保障（OR=6.11）、全额资助的继续教育发展计划（OR=2.84）和先进医疗设施的获取（OR=2.35）。
研究结果表明，需要制定一个综合的干预方案，特别强调安全保障，以留住偏远地区的医疗专家。还建议提供财政激励措施以提高留用率。然而，必须认识到，没有单一的干预措施是足够的，因为影响印度尼西亚偏远地区专家留用的因素是复杂和多方面的。
