Turnover intention and related factors among general practitioners in China

Objective To investigate the prevalence of turnover intention among general practitioners (GPs) in China and explore its influencing factors. Methods A stratified random sampling method was used to conduct a WeChat questionnaire survey on 3 244 GPs working in community health centers in China (East, Beijing, Shanghai, Guangdong, and Zhejiang; Central, Hubei, Heilongjiang, Henan, and Anhui; Western, Sichuan, Guizhou, Yunnan, and Inner Mongolia) between October 2017 and January 2018. The questionnaire of occupational attractiveness of GPs was self-designed. It included basic information of GPs job satisfaction, burnout, and turnover intention. The Chinese version of the turnover intention scale was modified according to the studies by Mickael and Spector. The chi-square test was conducted to compare the differences of the turnover intention in different groups, and multivariable logistic stepwise regression analysis was used to analyze the influencing factors for turnover intention among GPs. Results The results showed that 35.20% of the general practitioners had higher intention to leave their present positions, including 33.69% in the Eastern China, 39.24% in the Central China, and 33.20% in the Western China. Multivariable logistic stepwise regression analysis showed that male GPs, the Central China region, the younger, a higher educational level, with administrative responsibility, at a higher professional title, at a lower level of material satisfaction, at a lower level of relationship satisfaction, at a lower level of growth satisfaction, at a higher scores on serious emotional exhaustion, and at a higher scores on depersonalization were the significant factors associated with turnover intention. Conclusion The overall willingness of GPs to leave general practices is high in China, and the associated factors for turnover intention among GPs are complex. Actions such as expanding the career prospects of GPs, increasing the wages of GPs, enhancing the occupational attractiveness, and improving the occupational mental health of GPs, are needed to reduce the turnover intention of GPs.