title: Who should receive recruitment and retention incentives? Improved targeting of rural doctors using medical workforce data.
abstract: OBJECTIVE
  The objective of this study was to define an improved classification for allocating incentives to support the recruitment and retention of doctors in rural Australia.
  
  
  METHODS
  Geo-coded data (n = 3636 general practitioners (GPs)) from the national Medicine in Australia: Balancing Employment and Life study were used to examine statistical variation in four professional indicators (total hours worked, public hospital work, on call after-hours and difficulty taking time off) and two non-professional indicators (partner employment and schooling opportunities) which are all known to be related to difficulties with recruitment and retention.
  
  
  METHODS
  The main outcome measure used for the study was an association of six sentinel indicators for GPs with practice location and population size of community.
  
  
  RESULTS
  Four distinct homogeneous population size groups were identified (0-5000, 5001-15,000, 15,001-50,000 and >50,000). Although geographical remoteness (measured using the Australian Standard Geographical Classification-Remoteness Areas (ASGC-RA)) was statistically associated with all six indicators (P < 0.001), population size provided a more sensitive measure in directing where recruitment and retention incentives should be provided. A new six-level rurality classification is proposed, based on a combination of four population size groups and the five ASGC-RA levels. A significant increase in statistical association is measured in four of six indicators (and a slight increase in one indicator) using the new six-level classification versus the existing ASGC-RA classification.
  
  
  CONCLUSIONS
  This new six-level geographical classification provides a better basis for equitable resource allocation of recruitment and retention incentives to doctors based on the attractiveness of non-metropolitan communities, both professionally and non-professionally, as places to work and live.
authors.affiliation: Centre of Research Excellence in Rural and Remote Primary Health Care and School of Rural Health, Monash University, Bendigo, Victoria, Australia. john.humphreys@monash.edu
authors.forename: John S
authors.initials: JS
authors.lastname: Humphreys
authors.forename: Matthew R
authors.initials: MR
authors.lastname: McGrail
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Joyce
authors.forename: Anthony
authors.initials: A
authors.lastname: Scott
authors.forename: Guyonne
authors.initials: G
authors.lastname: Kalb
mesh_terms: D001315:Australia; D002755:Choice Behavior; D016208:Databases, Factual; D058005:General Practitioners / Q000600:supply & distribution*; D006801:Humans; D008507:Medically Underserved Area; D009042:Motivation; D010558:Personnel Loyalty; D010560:Personnel Selection / Q000191:economics*; D040841:Resource Allocation; D019035:Rural Health Services; D011795:Surveys and Questionnaires; D016526:Workload / Q000706:statistics & numerical data