title: The impact of pecuniary and non-pecuniary incentives for attracting young doctors to rural general practice.
abstract: Shortages of GPs in rural areas constitute a profound health policy issue worldwide. The evidence for the effectiveness of various incentives schemes, which can be specifically implemented to boost recruitment to rural general practice, is generally considered to be poor. This paper investigates young doctors' preferences for key job attributes in general practice (GP), particularly concerning location and income, using a discrete choice experiment (DCE). The subjects were all final year medical students and interns in Norway (N = 1562), of which 831 (53%) agreed to participate in the DCE. Data was collected in November-December 2010. Policy simulations were conducted to assess the potential impact of various initiatives that can be used to attract young doctors to rural areas. Most interestingly, the simulations highlight the need to consider joint policy programs containing several incentives if the policies are to have a sufficient impact on the motivation and likelihood to work in rural areas. Furthermore, we find that increased income seem to have less impact as compared to improvements in the non-pecuniary attributes. Our results should be of interest to policy makers in countries with publicly financed GP systems that may struggle with the recruitment of GPs in rural areas.
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Norway. Electronic address: jon.h.holte@uit.no.
authors.forename: Jon Helgheim
authors.initials: JH
authors.lastname: Holte
authors.affiliation: COHERE, Department of Business and Economics, University of Southern Denmark, Denmark.
authors.forename: Trine
authors.initials: T
authors.lastname: Kjaer
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Norway.
authors.forename: Birgit
authors.initials: B
authors.lastname: Abelsen
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Norway; Centre for Health Economics, Monash University, Melbourne, Australia.
authors.forename: Jan Abel
authors.initials: JA
authors.lastname: Olsen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001499:Bayes Theorem; D002321:Career Choice; D002322:Career Mobility; D002755:Choice Behavior; D005194:Family Practice / Q000191:economics; D005260:Female; D006801:Humans; D007182:Income; D007407:Interviews as Topic; D007588:Job Satisfaction; D008297:Male; D017059:Models, Econometric; D009664:Norway; D010558:Personnel Loyalty; D010820:Physicians / Q000600:supply & distribution*; D011365:Professional Practice Location; D036301:Qualitative Research; D019035:Rural Health Services / Q000191:economics; D014940:Work Schedule Tolerance; D000078329:Workforce
keywords: Discrete choice experiments; General practice; Incentives; Norway; Reference dependence; Rural; Young doctors