FactorsPredictingJobRetentionAmongEmergency Physicians in Ministry of Public Health Hospitals

Abstract

Introduction
Emergency physicians are essential in managing critically ill patients in hospitals under Thailand’s Ministry of Public Health (MOPH). However, high workloads, workplace stress, and inadequate compensation contribute to resignations and job instability, posing a challenge to health system sustainability.
Objectives
To identify personal and organizational factors predicting job retention among emergency physicians and propose policy recommendations to strengthen workforce sustainability.
Methods
This analytic survey included 238 emergency physicians from a national population of 614 (as of July 1, 2025). Data were collected using a four-part questionnaire: demographics, organizational factors, job retention, and open-ended responses. Content validity was high (IOC=0.94), with excellent reliability (Cronbach’s alpha=0.959). Descriptive statistics and stepwise multiple regression were applied.
Results
Participants were mostly female (61.3%), median age 35 years, holding professional-level positions (75.2%). The most common income was 70,001–90,000 THB (38.2%). “Work relationships” scored highest (3.92±0.72), while “compensation and benefits” scored lowest (3.08±0.76). Average job retention was 3.07±1.02, indicating uncertainty. Significant predictors were working in tertiary hospitals (β=0.16, p=0.006), longer tenure (β=0.13, p=0.027), income 30,001–50,000 THB (β=0.11, p=0.042), and f inancial adequacy with savings (β=-0.12, p=0.030). Organizational factors included work–life balance (β=0.34, p<0.001) and leadership policies (β=0.22, p=0.002). The model explained 34% of variance in retention (R²=0.34, p<0.001).
Conclusion
Job retention among emergency physicians is shaped by both personal and organizational factors, especially work–life balance and leadership. To sustain this critical workforce, the MOPH should strengthen organizational structures, provide supportive systems, and adopt fair policies aligned with actual working conditions.