Determinants Influencing Turnover Intention Among Doctors in East Nusa Tenggara, Indonesia

Abstract

Objective: High turnover intention among rural doctors disrupts healthcare services and increases organizational costs associated with recruitment and training. This research aims to investigate doctors’ turnover intentions and analyse the associated factors that influence them in East Nusa Tenggara (ENT), a remote region in Indonesia.

Design: Doctors’ turnover intentions at a single point of time were measured quantitatively with cross-sectional approach. Data were collected through a structured questionnaire comprising 120 questions, designed to measure turnover intention as the key variable and its related factors. The responses from the questionnaire will be analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM), a statistical technique that allows for the examination of complex relationships between multiple variables and their direct or indirect effects on turnover intention.

Setting: This study was conducted in ENT, Indonesia, where 13 of 21 regencies are classified as "3T" (In Indonesian: Terdepan, Tertinggal, Terluar; means: frontier, underdeveloped, outermost). Limited healthcare facilities and professionals hinder service access. Challenges, including poor infrastructure, often lead to doctors’ resignation, disrupting healthcare delivery in these remote regions.

Results: Data were collected from 202 general practitioners and specialists in East Nusa Tenggara (ENT) through an online survey. Among the participants, 45.54% expressed an intention to resign. The results indicate that working engagement, pay satisfaction, opportunities for learning and development, work-life balance, and personal accomplishment influence turnover intention through job satisfaction as a mediating variable. Additionally, burnout was found to directly affect turnover intention.

Conclusion: This study highlights the importance of targeted interventions—ensuring fair pay, growth opportunities, balanced workloads, and supportive work environments—along with addressing burnout to reduce doctor turnover in East Nusa Tenggara (ENT). By identifying key turnover factors, it offers valuable insights for policymakers and hospital management to develop effective retention strategies, ensuring sustainable, high-quality healthcare in ENT.