Whether Financial Measure Retains Doctors in Rural areas: A Cohort Study to Follow up Doctors after the Compulsory Public Service Ended - ผลของการเพิ่มค่าตอบแทนต่อการคงอยู่ในแพทย์ชนบท ภายหลังสิ้นสุดสัญญาใช้ทุน

Abstract

The study was aimed at assessment of the impacts of financial measure on rural retention of
doctors. The study used the cohort approach, and 282 physicians serving in years 1-3 from 9 provinces
were included in the sample. Doctors were followed up 3 years, and secondary data of the
Ministry of Public Health as well as telephone interview were used for data collection. Statistical
tests used were descriptive and logistic regression.
A 3-year follow up results showed that turnover rate of young doctors was still persistent. Low
proportion of doctors was retained at rural hospitals after the compulsory public service ended, at
31.3 percent, even after the financial measures implementation. Approximately half of them were
on the specialty training, and 20.3 percent were working at regional/provincial hospitals. The results
also showed that high rural retention was found among doctors having rural background and
graduated from regional universities.
It is suggested that to retain doctor in rural it needs both the financial and non-financial measures
in an appropriate combination. It is also suggested that the project to recruit medical doctors
from rural and to locally train plus hometown placement is likely to be effective measure to attract
and retain doctors in rural areas.
Key words: financial incentive, doctors, rural retention