What retains the remote health workforce? Quantifying retention priorities in remote Australia using Best-Worst
Tracks
Concurrent Room 4
| Thursday, August 6, 2026 |
| 4:05 PM - 4:25 PM |
| Concurrent Room 4 |
Overview
Dr Nanda Budhathoki, Menzies School Of Health
Details
1. Retention preferences differed by First Nations status. First Nations staff had significantly higher preference for: more First Nations leadership; ensuring more on-Country training for First Nations staff; increasing promotion opportunities; and celebrating staff achievements.
2. Overall, there were two distinct groups of remote primary health care staff. One group had a significantly stronger preference for: First Nations leadership; and significantly weaker preferences for: retention bonuses; higher salary; living cost subsidies; and annual leave and flexible time off.
3. Findings highlight the need for remote PHC services to understand staff preferences so that retention policies can be tailored to individuals.
Speaker
Dr Nanda Kaji Budhathoki
Research Fellow
Menzies School Of Health Research
What retains the remote health workforce? Quantifying retention priorities in remote Australia using Best-Worst Scaling
Presentation Overview
Background: Remote Australian primary health care (PHC) services experience persistent workforce shortages and excessive staff turnover, resulting in low continuity of care and poor health outcomes: ‘We don’t trust them when they change’. While it is essential that remote PHC services reduce turnover, little is known about staff preferences for retention initiatives.
Objective: Quantify retention initiative preferences of remote PHC workers
Method: Best-Worst Scaling survey of staff working in remote Australian PHC services, using conditional logit modelling and latent class analysis to quantify preferences.
Results: 228 respondents completed the survey. Overall, the most preferred retention initiatives (and preference scores) were: provision of a retention bonus (100), additional annual leave and flexible time-off (88); support for training, higher education (79); strengthened professional support networks and wellbeing engagement (71); and higher salary (68).
Preference scores differed significantly by First Nations status. First Nations staff preferred improving First Nations leadership (100 v 39), ensuring more on-Country training for First Nations staff (83 v 22); increasing promotion opportunities (87 v 0); celebrating staff achievements (86 v 29); and increased employment for local First Nations community members (77 v 22).
Latent class analysis identified two groups who differed in retention initiative preferences. Group 1 respondents had significantly higher preferences for First Nations leadership (71 v 30) and significantly lower preferences for financial incentives such as retention bonuses (40 v 100); higher salary (0 v 92); cost of living subsidies (8 v 80); and annual leave and flexible time off (38 v 91).
Conclusion: The study findings provide, for the first time, important quantitative evidence that remote PHC services can use to design tailored retention packages for their staff. The findings indicate that a targeted package of retention initiatives may be required to influence different staff groups.
Keywords: Health workforce retention, remote health, preferences, strategies
Objective: Quantify retention initiative preferences of remote PHC workers
Method: Best-Worst Scaling survey of staff working in remote Australian PHC services, using conditional logit modelling and latent class analysis to quantify preferences.
Results: 228 respondents completed the survey. Overall, the most preferred retention initiatives (and preference scores) were: provision of a retention bonus (100), additional annual leave and flexible time-off (88); support for training, higher education (79); strengthened professional support networks and wellbeing engagement (71); and higher salary (68).
Preference scores differed significantly by First Nations status. First Nations staff preferred improving First Nations leadership (100 v 39), ensuring more on-Country training for First Nations staff (83 v 22); increasing promotion opportunities (87 v 0); celebrating staff achievements (86 v 29); and increased employment for local First Nations community members (77 v 22).
Latent class analysis identified two groups who differed in retention initiative preferences. Group 1 respondents had significantly higher preferences for First Nations leadership (71 v 30) and significantly lower preferences for financial incentives such as retention bonuses (40 v 100); higher salary (0 v 92); cost of living subsidies (8 v 80); and annual leave and flexible time off (38 v 91).
Conclusion: The study findings provide, for the first time, important quantitative evidence that remote PHC services can use to design tailored retention packages for their staff. The findings indicate that a targeted package of retention initiatives may be required to influence different staff groups.
Keywords: Health workforce retention, remote health, preferences, strategies
Biography
Nanda is an environmental and health economist specialising in climate change, disaster risk management, behavioural economics, focusing on quantitative research approaches. He began working with Menzies in June 2021 as a part-time research and data analyst for the “SP Plus” project before joining the University of Queensland (UQ) in 2022 as a Postdoctoral Research Fellow. Nanda returned to Menzies as a research fellow, where his work now focuses on improving workforce retention through evidence-based research, strengthening remote health services and systems through and assessing the cost and health impacts of short-term health staffing in remote Australia.
