Objective To investigate the prevalence of turnover intention and its influencing factors among general practitioners (GPs) in the Eastern, Central and Western China and to provide evidences for policymaking on the improvement of GPs system.
Methods With stratified multistage random sampling, we recruited 3 244 GPs from 360 community health service institutions in 12 provinces, cities or autonomous regions in the Eastern, Central and Western China; then we conducted an online questionnaire survey among the GPs via WeChat between October 2017 and February 2018.
Results For the 3 236 GPs with valid responses, the total turnover intention score was 15.07 ± 4.33 assessed by a scale with marks from 6 to 24; for the GPs in Eastern, Central and Western China, the total turnover intention score was 15.11 ± 4.10, 15.26 ± 4.52, and 14.83 ± 4.40, respectively. The number (percentage) of GPs assessed with the highest, higher, lower, and the lowest turnover intention was 667 (20.61%), 1 633 (50.46%), 728 (22.50%), and 208 (6.43%), respectively. The results of multivariate linear stepwise regression analysis demonstrated that: (1) among all the GPs, those with a bachelor degree or higher education, employed under a temporal work contract, with heavy work stress, with a higher emotional exhaustion score, with a higher depersonalization score, and with higher personal accomplishment score were more likely to have a higher turnover intention, while those being female, at elder age, without an administrative responsibility, with a higher score for material satisfaction, and with a higher score for career development satisfaction were more likely to have a lower turnover intention; (2) among the GPs in Eastern China, those with a higher emotional exhaustion score were more likely to have a higher turnover intention and those at elder age, without an administrative responsibility, having an average annual personal income of ≥ 50 000 RMB yuan, with a higher score for material satisfaction, and with a higher score for career development satisfaction were more likely to have a lower turnover intention; (3) among the GPs in Central China, those with a bachelor education, employed under a temporal work contract, with a higher emotional exhaustion score, with a higher depersonalization score, and with a higher personal accomplishment score were more likely to have a higher turnover intention; but those with a higher score for material satisfaction and with a higher score for career development satisfaction were more likely to have a lower turnover intention; and (4) among the GPs in Western China, those with a bachelor degree or higher education, employed under a temporal work contract, with heavy work stress, and with a higher emotional exhaustion score were more likely to have a higher turnover intention, but those being female, at elder age, with a higher score for material satisfaction, and with a higher score for career development satisfaction were more likely to have a lower turnover intention.
Conclusion The turnover intention is relatively high and mainly influenced by gender, age, education, employment contract, administrative responsibility, work stress, material satisfaction, career development satisfaction, emotional exhaustion, depersonalization, and personal accomplishment among GPs in Eastern, Central and Western China.
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