Learning Objective– Identify factors associated with retention of primary care clinicians at National Health Service Corps sites. Abstract text: The National Health Service Corps’ (NHSC) scholarship (SCH, tuition for service) and loan repayment (LRP, debt payoff for service) programs have recruited many health professionals to work in community health centers (CHCs) and underserved areas over the last 25 years. Most previous retention assessments were limited to physicians, rural sites or scholarship recipients. We used NHSC files to identify 9,726 physician and non-physician primary care clinicians serving between 1980 and 1997. A survey covering background, education, expectations and experiences before, during and after service at NHSC sites was mailed to a sample of these clinicians. Univariate statistics were calculated using complex weights to adjust for sampling and nonresponse. Bi-variate relationships between same site retention and predictors were examined using chi-square and t-tests; and Cox regression models were constructed to assess the relative importance of individual, site (CHC vs. other; rural vs. urban), program (SCH vs. LRP) and cohort (pre-1988, post 1988) effects. Preliminary models employing survey data from 1024 clinicians (59% response) suggest that the risk of turnover for clinicians in the scholarship program prior to 1988, was 1.67 times that of clinicians in the newer loan repayment program instituted since 1988. Other important risks of leaving a site include: being a nonphysician (hazard=1.16; 95%CI=1.04,1.28); working in a C/MHC or Indian Health Service site (hazard=1.15 (95%CI=1.02,1.31) and a lower starting salary (hazard: 1.03; CI-1.01,1.06).
Learning Objectives: Identify factors associated with retention of primary care clinicians in at National Health Service Corps sites
Keywords: Community-Oriented Primary Care, Underserved Populations
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: HRSA, NHSC
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.