Recruitment, retention and turnover of allied health professionals in rural and remote areas: a quantitative scoping review

Introduction: Complex challenges exist in the recruitment, retention and turnover of allied health professionals (AHPs) in rural and remote areas, which negatively impacts the provision of services. The aim of this review was to synthesise evidence from studies with a quantitative component to examine the length of employment of allied health professionals, and significant factors and costs associated with the recruitment, retention and turnover of the rural and remote allied health workforce. Methods: Six databases were searched, along with grey literature, to identify studies using a quantitative approach or a mixed-methods approach with a quantitative component. The review focused on quantitative approaches due to the gap in the literature in relation to quantitative data on rural and remote AHP recruitment and retention. Included studies had to report on either recruitment, retention, turnover, length of employment or associated costs such as vacancy and recruitment costs of allied health professionals in rural or remote settings. Data for each study–including costs, employment duration and any factors affecting recruitment, retention and turnover–were extracted. The factors were identified directly from the articles and then assigned into two overarching categories of ‘personal’ and ‘organisational’. The data were then further examined to identify if there were any significant relationships between the identified factors and recruitment, retention and turnover. Results: Twenty-four articles were included in the review. A variety of methods were used to measure length of employment. Overall, findings indicated that length of employment for rural and remote allied health professionals was often short with survival rates dropping substantially after 2 years of employment. Only two studies measured costs, and both indicated a relatively high cost associated with workforce turnover. A range of personal and organisational factors were identified that significantly impacted the recruitment, retention and turnover of allied health professionals in rural and remote areas. Conclusion: This review highlighted length of employment, personal and organisational factors influencing recruitment, retention and turnover and the associated costs. Having a rural background or undertaking a rural placement, being older, being integrated into the community, good working conditions and financial incentives positively impacted upon recruitment, retention and turnover. However, there was limited evidence available on costs, which indicates a need for more research to be undertaken in this area. A variety of methods were used to measure length of employment, recruitment, retention and turnover, and currently a standardised framework does not exist to collectively synthesise data. Therefore, future research should focus on developing and then using a rigorous framework to better aid synthesisation of data analysis to inform practice and policy.