Work-pressure, job-satisfaction and turnover intentions among health managers in Serbia

Abstract

Abstract Background Rationalization, freezing of salaries and additional taxation of salaries above a certain amount have marked the reform of the public health sector in Serbia in 2014/15. Health managers bear responsibility for success in reform activities, and improvement of subordinates’ job satisfaction and health care quality with constrained resources. This study explored factors associated with work-pressure, turnover intentions and job satisfaction among health managers in 323 public health institutions in Serbia. Methods Data of the 2015 job satisfaction survey of the Ministry of Health and the Serbian Public Health Institute were used to carry out a secondary analysis. Logistic regression was applied, including factors such as age, gender, occupation (doctors, nurses, other health workers, healthcare associates and non-medical managers), workplace, work-conditions’ satisfaction, general job satisfaction, and turnover intention in relation to work-pressure of 7818 health managers (response rate was 91.5%). Results Almost 39.5% of the health managers experienced high/very high work-pressure (p < 0.001), 51.2% were dissatisfied (p < 0.001), and 23.7% had turnover intention outside the health sector/country (p < 0.001). High/very high work-pressure positively correlated with health managers of secondary (Odds Ratio-OR =1.37, p < 0.001) and tertiary care institution (OR = 1.72, p < 0.001), female sex (OR = 1.19, p = 0.004), younger than 55 years of age (OR = 1.26, p < 0.001), and nurses (OR = 1.13, p = 0.024). Other factors showing positive correlations include job dissatisfaction in general (p < 0.001) and with all workplace conditions (p < 0.001), as well as turnover intentions (p < 0.001). Conclusions Work pressure of health managers seems to be perceived highest in the group of younger female nurse executives in hospital care. Their dissatisfaction with the job in general and with the working conditions, as well as turnover intentions positively correlate with the increase of work pressure. Key messages Improving working conditions and job satisfaction is key to reduce work pressure of health managers. Young female nurse managers perceive highest levels of work pressure, and need reinforcement at work.