Factors affecting retention of allied health professionals working with people with disability in rural New South Wales, Australia: discrete choice experiment questionnaire development

Human Resources for Health

Jennie Brentnall¹  Anita Bundy¹  Michelle Lincoln¹  Craig Veitch¹  Kim Bulkeley¹  Angela Dew²  Gisselle Gallego¹ 

[1] Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, Lidcombe 1825, New South Wales, Australia;Faculty of Arts and Social Sciences, University of New South Wales, Sydney 2052, New South Wales, Australia

关键词: Disability;    Rural;    Retention;    Preferences;    Allied health professionals;    Discrete choice experiment;   

Others  :  1209207
DOI  :  10.1186/s12960-015-0013-7

 received in 2014-01-29, accepted in 2015-04-09,  发布年份 2015

【 摘 要 】

Objective

This paper describes the development of a discrete choice experiment (DCE) questionnaire to identify the factors (attributes) that allied health professionals (AHPs) working with people with disability identify as important to encouraging them to remain practising in rural areas.

Methods

Focus groups and semi-structured interviews were conducted with 97 purposively selected service providers working with people with disability in rural New South Wales, Australia. Focus groups and interviews were digitally recorded, transcribed, and analysed using a modified grounded theory approach involving thematic analysis and constant comparison.

Results

Six attributes that may influence AHPs working with people with disability in rural areas to continue to do so were inductively identified: travel arrangements, work flexibility, professional support, professional development, remuneration, and autonomy of practice. The qualitative research information was combined with a policy review to define these retention factors and ensure that they are amenable to policy changes.

Conclusion

The use of various qualitative research methods allowed the development of a policy-relevant DCE questionnaire that was grounded in the experience of the target population (AHPs).

【 授权许可】

   
2015 Gallego et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Australian Health Workforce Advisory Committee (AHWAC). The Australian Allied Health Workforce – an overview of workforce planning issues. Sydney; 2006. Available at: [http://www.ahwo.gov.au/documents/Publications/2006/The%20Australian%20allied%20health%20workforce.pdf] Accessed on 02 February 2015.
• [2]Buchan JM, Naccarella L, Brooks PM. Is health workforce sustainability in Australia and New Zealand a realistic policy goal? Aust Health Rev. 2011; 35(2):152-5.
• [3]Becker S. Critical shortage of allied health professionals in the disability sector. Sydney: National Disability Service (NDS) National Workforce Committee; 2011. Available from: [file:///C:/Users/giga0007/Downloads/Shortage_of_allied_health_professionals_in_the_disability_sector%20(2).pdf]. Accessed on 16 April 2015
• [4]Keane S, Lincoln M, Smith T. Retention of allied health professionals in rural New South Wales: a thematic analysis of focus group discussions. BMC Health Serv Res. 2012; 12:175. BioMed Central Full Text
• [5]National Disability Insurance Scheme. [http://www.ndis.gov.au/what-is-the-ndis] Accessed on 02 February 2015.
• [6]Bundy A, Hemsley B, Brentnall J, Marshall E. Therapy services in the disability sector: literature review. NSW Department of Ageing, Disability and Home Care, Sydney, NSW; 2008.
• [7]Chedid R, Lincoln M, Veitch C, Bundy A, Gallego G, Dew A et al.. How many allied health professionals are employed in the disability sector in rural and remote NSW and how often do they leave the sector?. Sydney, Australasian Society for Intellectual Disability; 2013.
• [8]Health Workforce Australia. Australia’s health workforce series – physiotherapists in focus. 2014. Available from: [https://www.hwa.gov.au/sites/default/files/HWA_Australia-Health-Workforce-Series_Physiotherapists-in-focus_vF_LR.pdf] Accessed on 02 February 2015.
• [9]Health Workforce Australia. Australia’s health workforce series – speech pathologists in focus. 2014. Available from: [http://www.hwa.gov.au/publication/speech-pathologists-focus-0] Accessed on 02 February 2015.
• [10]Lincoln M, Gallego G, Dew A, Bulkeley K, Veitch C, Bundy A et al.. Recruitment and retention of allied health professionals in the disability sector in rural and remote New South Wales Australia. J Intell Disabil Res. 2014; 39(1):86-97.
• [11]Commission AGP. Disability care and support - Productivity Commission Inquiry Report. Canberra, Commonwealth of Australia; 2011.
• [12]National Disability Services (NDS). Forming a national disability workforce strategy. Discussion Paper. National Disability Services; 2014.
• [13]National Disability Services Victoria. Workforce strategy. National Disability Services Victoria; 2011. Available from: [http://www.nds.org.au/projects/article/33#NDSVictoriaWorkforceStrategy].
• [14]Lievens T, Lindelow M, Serneels P. Understanding health workforce issues: a selective guide to the use of qualitative methods. In: Handbook on Monitoring and Evaluation of Human Resources for Health. World Health Organization, Geneva; 2009: p.129-146.
• [15]Vujicic M, Shengelia B, Alfano M, Thu HB. Physician shortages in rural Vietnam: using a labor market approach to inform policy. Soc Sci Med. 2011; 73(7):970-7.
• [16]Hanson K, Jack W. Health worker preferences for job attributes in Ethiopia: results from a discrete choice experiment. Working Paper. Georgetown University, Washington, DC; 2008.
• [17]Lagarde M, Blaauw D. A review of the application and contribution of discrete choice experiments to inform human resources policy interventions. Hum Resour Health. 2009; 7:62. BioMed Central Full Text
• [18]Mangham LJ, Hanson K. Employment preferences of public sector nurses in Malawi: results from a discrete choice experiment. Trop Med Int Health. 2008; 13(12):1433-41.
• [19]Lancsar E, Louviere J. Conducting discrete choice experiments to inform healthcare decision making: a user’s guide. Pharmacoeconomics. 2008; 26(8):661-77.
• [20]de Bekker-Grob EW, Ryan M, Gerard K. Discrete choice experiments in health economics: a review of the literature. Health Econ. 2012; 21(2):145-72.
• [21]3218.0 - Regional Population Growth, Australia, 2011–12. [http://www.abs.gov.au/websitedbs/censushome.nsf/home/tablebuilder?opendocument&navpos=240] Accessed on 02 February 2015.
• [22]Census of population and housing 2011. Persons, place of usual residence by LGA [Table Builder]. [http://www.abs.gov.au/websitedbs/censushome.nsf/home/tablebuilder?opendocument&navpos=240] Accessed on 02 Feb 2015
• [23]Creswell JW. Qualitative inquiry & research design: choosing among five approaches. 2nd ed. Sage Publications, Thousand Oaks, CA; 2007.
• [24]Bryman A. Social research methods. 3rd ed. Oxford University Press, Oxford; 2001.
• [25]Veitch C, Dew A, Bulkeley K, Lincoln M, Bundy A, Gallego G et al.. Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policy-makers, managers and senior therapists. Rural Remote Health. 2012; 12(2):1903.
• [26]Veitch C, Lincoln M, Bundy A, Gallego G, Dew A, Bulkeley K et al.. Integrating evidence into policy and sustainable disability services delivery in western New South Wales Australia: the ‘wobbly hub and double spokes’ project. BMC Health Serv Res. 2012; 12:70. BioMed Central Full Text
• [27]Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006; 3:77-101.
• [28]Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. Sage, Thousand Oaks; 2006.
• [29]Graham CM. Professional staff contributions to positive student outcomes: a case study. Aust Univ Rev. 2013; 55(1):7-16.
• [30]Dew A, Gallego G, Bulkeley K, Veitch C, Lincoln M, Bundy A et al.. Policy development and implementation for disability services in rural New South Wales Australia. J Policy Pract Intel. 2014; 11(3):200-9.
• [31]Al-Janabi H, Coast J, Flynn TN. What do people value when they provide unpaid care for an older person? A meta-ethnography with interview follow-up. Soc Sci Med. 2008; 67(1):111-21.
• [32]Coast J, Al-Janabi H, Sutton EJ, Horrocks SA, Vosper AJ, Swancutt DR et al.. Using qualitative methods for attribute development for discrete choice experiments: issues and recommendations. Health Econ. 2012; 21(6):730-41.
• [33]Ryan M. Using consumer preferences in health care decision making: the application of conjoint analysis. Office of Health Economics, London; 1996.
• [34]O’Toole K, Schoo A, Hernan A. Why did they leave and what can they tell us? Allied health professionals leaving rural settings. Aust Health Rev. 2010; 34(1):66-72.
• [35]Campbell N, McAllister L, Eley D. The influence of motivation in recruitment and retention of rural and remote allied health professionals: a literature review. Rural Remote Health. 2012; 12:1900.
• [36]Keane S, Smith T, Lincoln M, Fisher K. Survey of the rural allied health workforce in New South Wales to inform recruitment and retention. Aust J Rural Health. 2011; 19(1):38-44.
• [37]Mills A, Millsteed J. Retention: an unresolved workforce issue affecting rural occupational therapy services. Aust OccupTher J. 2002; 49(4):170-81.
• [38]Schoo AM, Stagnitti KE, Mercer C, Dunbar J. A conceptual model for recruitment and retention: allied health workforce enhancement in Western Victoria Australia. Rural Remote Health. 2005; 5(4):477.
• [39]Denham LA, Shaddock AJ. Recruitment and retention of rural allied health professionals in developmental disability services in New South Wales. Aust J Rural Health. 2004; 12(1):28-9.
• [40]Wielandt PM, Taylor E. Understanding rural practice: implications for occupational therapy education in Canada. Rural Remote Health. 2010; 10(3):1488.
• [41]Bent A. Allied health in Central Australia: challenges and rewards in remote area practice. Aust J Physiother. 1999; 45(3):203-12.
• [42]Gillham S, Ristevski E. Where do I go from here: we’ve got enough seniors? Aust J Rural Health. 2007; 15(5):313-20.
• [43]Grewal I, Lewis J, Flynn T, Brown J, Bond J, Coast J. Developing attributes for a generic quality of life measure for older people: preferences or capabilities? Soc Sci Med. 2006; 62(8):1891-901.
• [44]Fitzpatrick E, Graham ID, Durieux-Smith A, Angus D, Coyle D. Parents’ perspectives on the impact of the early diagnosis of childhood hearing loss. Int J Audiol. 2007; 46(2):97-106.
• [45]Witter S. Thi Thu Ha B, Shengalia B, Vujicic M. Understanding the ‘four directions of travel’: qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam. Hum Resour Health. 2011; 9(1):20. BioMed Central Full Text
• [46]Ke KM, Mackichan F, Sandy JR, Ness AR, Hollingworth W. Parents’ perspectives on centralized cleft services for children: the development of a DCE questionnaire. Oral Dis. 2013; 19(2):185-92.
• [47]Coast J, Horrocks S. Developing attributes and levels for discrete choice experiments using qualitative methods. J Health Serv Res Policy. 2007; 12(1):25-30.