Abstract
This study aimed to assess the impact of a financial measure on public and rural facility retention of
physicians in Thailand. It used a retrospective approach using secondary data from the Ministry of Public
Health (MoPH). The study population included all physicians who graduated and entered the workforce
during 2001-2007, and the data were retrieved from 2001-2011. Survival analysis was used.
Results showed that the high turnover rate of young physicians was still persistent. Large proportions
of physicians, at about 30%, resigned before the 3-year compulsory contract ended, and this trend
repeated even after the financial measure was implemented. Resignations from MoPH have increased
since 2001, and the rate remained high after the increase of special allowance. Rural retention was low,
especially after 3 years of compulsory public services. The proportion of physicians retained in the rural
area after the 3-year compulsory period was about 20-24%, and this trend repeated even after implementation
of the financial measures in 2009.
The results suggested that to retain physicians in the rural area we need both the financial and nonfinancial
measures in an appropriate combination. Non-financial measures such as, working close to hometown,
opportunities for specialist training, improvement of work environment and infrastructure would
be important for rural retention of physicians as well.
