Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment.
Doctors' scarcity in rural areas remains a serious problem in Latin America and Peru. Few studies have explored job preferences of doctors working in underserved areas. We aimed to investigate doctors' stated preferences for rural jobs.A labelled discrete choice experiment (DCE) was perfor...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2012-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC3525596?pdf=render |
id |
doaj-09ea013adc6a4746a15207c1db35a9bf |
---|---|
record_format |
Article |
spelling |
doaj-09ea013adc6a4746a15207c1db35a9bf2020-11-25T02:47:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01712e5056710.1371/journal.pone.0050567Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment.J Jaime MirandaFrancisco Diez-CansecoClaudia LemaAndrés G LescanoMylene LagardeDuane BlaauwLuis HuichoDoctors' scarcity in rural areas remains a serious problem in Latin America and Peru. Few studies have explored job preferences of doctors working in underserved areas. We aimed to investigate doctors' stated preferences for rural jobs.A labelled discrete choice experiment (DCE) was performed in Ayacucho, an underserved department of Peru. Preferences were assessed for three locations: rural community, Ayacucho city (Ayacucho's capital) and other provincial capital city. Policy simulations were run to assess the effect of job attributes on uptake of a rural post. Multiple conditional logistic regressions were used to assess the relative importance of job attributes and of individual characteristics. A total of 102 doctors participated. They were five times more likely to choose a job post in Ayacucho city over a rural community (OR 4.97, 95%CI 1.2; 20.54). Salary increases and bonus points for specialization acted as incentives to choose a rural area, while increase in the number of years needed to get a permanent post acted as a disincentive. Being male and working in a hospital reduced considerably chances of choosing a rural job, while not living with a partner increased them. Policy simulations showed that a package of 75% salary increase, getting a permanent contract after two years in rural settings, and getting bonus points for further specialisation increased rural job uptake from 21% to 77%. A package of 50% salary increase plus bonus points for further specialisation would also increase the rural uptake from 21% to 52%.Doctors are five times more likely to favour a job in urban areas over rural settings. This strong preference needs to be overcome by future policies aimed at improving the scarcity of rural doctors. Some incentives, alone or combined, seem feasible and sustainable, whilst others may pose a high fiscal burden.http://europepmc.org/articles/PMC3525596?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
J Jaime Miranda Francisco Diez-Canseco Claudia Lema Andrés G Lescano Mylene Lagarde Duane Blaauw Luis Huicho |
spellingShingle |
J Jaime Miranda Francisco Diez-Canseco Claudia Lema Andrés G Lescano Mylene Lagarde Duane Blaauw Luis Huicho Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment. PLoS ONE |
author_facet |
J Jaime Miranda Francisco Diez-Canseco Claudia Lema Andrés G Lescano Mylene Lagarde Duane Blaauw Luis Huicho |
author_sort |
J Jaime Miranda |
title |
Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment. |
title_short |
Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment. |
title_full |
Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment. |
title_fullStr |
Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment. |
title_full_unstemmed |
Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment. |
title_sort |
stated preferences of doctors for choosing a job in rural areas of peru: a discrete choice experiment. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2012-01-01 |
description |
Doctors' scarcity in rural areas remains a serious problem in Latin America and Peru. Few studies have explored job preferences of doctors working in underserved areas. We aimed to investigate doctors' stated preferences for rural jobs.A labelled discrete choice experiment (DCE) was performed in Ayacucho, an underserved department of Peru. Preferences were assessed for three locations: rural community, Ayacucho city (Ayacucho's capital) and other provincial capital city. Policy simulations were run to assess the effect of job attributes on uptake of a rural post. Multiple conditional logistic regressions were used to assess the relative importance of job attributes and of individual characteristics. A total of 102 doctors participated. They were five times more likely to choose a job post in Ayacucho city over a rural community (OR 4.97, 95%CI 1.2; 20.54). Salary increases and bonus points for specialization acted as incentives to choose a rural area, while increase in the number of years needed to get a permanent post acted as a disincentive. Being male and working in a hospital reduced considerably chances of choosing a rural job, while not living with a partner increased them. Policy simulations showed that a package of 75% salary increase, getting a permanent contract after two years in rural settings, and getting bonus points for further specialisation increased rural job uptake from 21% to 77%. A package of 50% salary increase plus bonus points for further specialisation would also increase the rural uptake from 21% to 52%.Doctors are five times more likely to favour a job in urban areas over rural settings. This strong preference needs to be overcome by future policies aimed at improving the scarcity of rural doctors. Some incentives, alone or combined, seem feasible and sustainable, whilst others may pose a high fiscal burden. |
url |
http://europepmc.org/articles/PMC3525596?pdf=render |
work_keys_str_mv |
AT jjaimemiranda statedpreferencesofdoctorsforchoosingajobinruralareasofperuadiscretechoiceexperiment AT franciscodiezcanseco statedpreferencesofdoctorsforchoosingajobinruralareasofperuadiscretechoiceexperiment AT claudialema statedpreferencesofdoctorsforchoosingajobinruralareasofperuadiscretechoiceexperiment AT andresglescano statedpreferencesofdoctorsforchoosingajobinruralareasofperuadiscretechoiceexperiment AT mylenelagarde statedpreferencesofdoctorsforchoosingajobinruralareasofperuadiscretechoiceexperiment AT duaneblaauw statedpreferencesofdoctorsforchoosingajobinruralareasofperuadiscretechoiceexperiment AT luishuicho statedpreferencesofdoctorsforchoosingajobinruralareasofperuadiscretechoiceexperiment |
_version_ |
1724755362464137216 |