Evidence map›Paper›PMID 42449413›Full record

ArticleBMC health services research2026

Improving health workforce retention in remote Australia: a best-worst scaling study.

Nanda Kaji Budhathoki, John S Humphreys, Supriya Mathew, Alan Cass, Yasmin Watts, Alexandra Edelman, Leisa McCarthy, Leander Menezes, Yuejen Zhao, Renee Williams and 12 more

Abstract read
In one paragraph

Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Nanda Kaji BudhathokiMenzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia. nanda.budhathoki@menzies.edu.au.
John S HumphreysMonash Rural Health, Monash University, Bendigo, VIC, Australia.
Supriya MathewMenzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.
Alan CassMenzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.
Yasmin WattsMenzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.
Alexandra EdelmanMenzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.
Leisa McCarthyMenzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.
Leander MenezesPintupi Homelands Health Service Aboriginal Corporation, Kintore, NT, Australia.
Yuejen ZhaoNorthern Territory Department of Health, Darwin, NT, Australia.
Renee WilliamsTorres Health Indigenous Corporation, Thursday Island, QLD, Australia.
Mark RamjanNorthern Territory Department of Health, Darwin, NT, Australia.
Sinon CooneyKatherine West Health Board, Katherine, NT, Australia.
Karrina DemasiDepartment for Health and Wellbeing, South Australia Health, Adelaide, SA, Australia.
John BoffaCentral Australian Aboriginal Congress, Alice Springs, NT, Australia.
Donna-Maree StephensDMS Research Evaluation Consulting, Darwin, NT, Australia.
Sean TaylorMelbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
Ashleigh McDonaldNorthern Territory PHN/Rural Workforce Agency NT, Darwin, NT, Australia.
Walbira MurrayAboriginal Medical Services Alliance Northern Territory (AMSANT), Alice Springs, NT, Australia.
Kahsu GebrekidanMenzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.
Kristal LawrenceMenzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.
John WakermanMenzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.
Deborah RussellMenzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.

Funding

the National Health and Medical Research Council's Centre of Research Excellence program [GNT2015611]
6 · The paper itself

Abstract

backgroundMany Australian remote primary health care (PHC) services are characterised by persistent workforce shortages and suboptimal staff retention, with patients experiencing low care continuity, culturally unsafe care, and consequently poorer health outcomes. This study aims to quantify preferences for remote PHC staff for different workforce retention initiatives.

methodsA Best-Worst Scaling (BWS) survey was administered (online and face-to-face) to staff working in remote Australian PHC services. Responses were analysed using conditional logit modelling and latent class analysis to determine differences in respondents' preferences.

results228 respondents completed the survey. The majority worked in an Aboriginal or Torres Strait Islander Community Controlled Health Service (ATSICCHS) (71%). Overall, the most preferred retention initiatives were provision of a retention bonus (preference score 100); additional annual leave and flexible time-off (88); support for training, higher education or research (79); strengthened professional support networks and wellbeing engagement (71); and higher salary (68). There were many similarities and some significant differences in preference scores between First Nations and non-Indigenous respondents. First Nations staff were significantly more likely to prefer increased First Nations leadership (100 versus 39); increased training and mentoring by local First Nations people (97 versus 55); increased opportunities for promotion or advancement (87 versus 0); increased recognition and celebrating staff achievements (86 versus 29); more on-Country training (83 versus 22); improved role recognition and clarity (79 versus 30); and employment for local First Nations community members (77 versus 22). Latent class analysis Group 2 members had significantly lower preference scores for First Nations leadership (30 versus 71) and on-Country training (27 versus 52) and significantly higher preferences for financial incentives such as retention bonuses (100 versus 40); higher salary (92 versus 0); annual leave and flexible time off (91 versus 38); and cost of living subsidies (80 versus 8).

conclusionsRetaining staff in remote PHC services is complex and staff preferences for retention initiatives vary. PHC services should package retention initiatives in bundles that are tailored to accommodate diverse staff preferences. These findings can inform context-specific retention initiatives by remote PHC services seeking to stabilise their workforce.

Indexed as

Health Services, IndigenousHealth WorkforcePersonnel TurnoverPrimary Health CareRural Health ServicesAdultAustraliaFemaleHumansJob SatisfactionMaleMiddle AgedSurveys and QuestionnairesBest-worst scalingFeasible strategiesFirst NationsHealth workforce retentionPreferencesPrimary health careRemote health

Identifiers

PMID42449413
PMCPMC13374182

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.