Stay or go? Exploring physician turnover in European Hospitals–Evidence from the METEOR survey

by Laura Maniscalco, Marco Enea, Peter de Winter, Neeltje de Vries, Anke Boone, Olivia Lavreysen, Kamil Baranski, Walter Mazzucco, Adriano Filadelfio Cracò, Malgorzata Kowalska, Szymon Szemik, Lode Godderis, Domenica Matranga

According to the World Health Organization (WHO), in 2022 there was a shortfall of approximately 1.2 million doctors, impacting healthcare system and patient care. Understanding turnover intentions is crucial for managing the healthcare workforce and ensuring continuous, and high-quality patient care. This study investigates the prevalence of physicians planning to leave their hospital or the profession, and risk factors such as job demand, resources, satisfaction, and burnout across four European countries. A cross-sectional multicenter study was conducted in eight hospitals across Belgium, the Netherlands, Poland and Italy, including both academic and non-academic institutions. Data from Poland were excluded due to a low response rate, to preserve respondent anonymity. Multivariable logistic regression analyses were performed, adjusted for country, demographics, and work context, using significant variables from the univariable analysis. The overall intention to leave the hospital was 16.5%, with the highest rates in Belgium (19.6%) and Italy (19%), and the lowest in the Netherlands (9.8%). The intention to leave the profession was 9.1%, with the highest rate in the Netherlands (16.1%), followed by Belgium (6.3%) and Italy (5.7%). Physicians at higher risk of leaving the hospital were younger (adjOR = 0.90, 95%CI = 0.86–0.93), lacked colleague support (adjOR = 3.18, 95%CI = 1.06–9.36), and were dissatisfied with job prospects (adjOR = 2.38, 95%CI = 1.02–5.54) and overall work (adjOR = 2.71, 95%CI = 1.09–6.69). Those more likely to leave the profession were from the Netherlands (adjOR = 4.14, 95%CI = 1.62–11.4), surgeons (adjOR = 2.90, 95%CI = 1.22–6.78), working in non-academic hospitals (adjOR = 2.43, 95%CI = 1.01–5.97), lacked development opportunities (adjOR = 5.97, 95%CI = 1.01–36.2), or were dissatisfied with career prospects (adjOR = 2.77, 95%CI = 1.04–7.27). Health system managers and relevant stakeholders involved in the planning, implementation, or evaluation of health policies and reforms aimed at improving healthcare job retention should take into account the key determinants of the intention to leave identified in this study.

Perceived Work Environment and Work‐Related Well‐Being in Nursing Homes: Comparison of Different Care Worker Groups

ABSTRACT

Background

A skilled and diverse healthcare workforce is essential in nursing homes, yet recruitment and retention remain a major challenge. Gaining insight into the well-being of different care worker groups and how they perceive their work environment can highlight areas of concern and opportunities for improvement.

Aims

To compare the perceived work environment and well-being among different care worker groups in nursing homes.

Methods

This descriptive study used cross-sectional survey data from the Flanders Nursing Home (FLANH) project, collected from February–July 2023. A total of 1521 care workers from 25 Flemish nursing homes participated (64.4% response rate), including care assistants (43.7%), registered nurses (20.5%), support staff (15.4%), allied health professionals (14.8%), and team leaders (5.7%). Chi-squared tests were used to compare the percentages of the care worker groups reporting the work environment items and well-being outcomes (job satisfaction, intention to leave, burnout). Post hoc analyses were conducted to identify which groups contributed to the significant differences observed.

Results

Significant differences among care worker groups were found for almost all work environment items and well-being outcomes. Staffing adequacy was perceived least among care assistants and registered nurses. More registered nurses and team leaders perceived high workload and emotional burden compared to the other groups. Work–life interference and involvement were perceived most among team leaders. A person-centered vision, work autonomy, and salary satisfaction were reported most among allied health professionals and team leaders. Skill use and training opportunities were reported least among support staff. Work-related well-being appeared to be experienced most among allied health professionals and least among care assistants.

Linking Evidence to Action

These findings highlight key differences in work environment perceptions and well-being among care worker groups, offering valuable insights for tailored initiatives to foster a supportive workplace that benefits the well-being of all types of care workers in nursing homes.