Introduction

In modern society, the healthcare sector plays a vital role in determining the quality of life and the level of national development. The effectiveness, accessibility, and quality of healthcare services depend not only on technology and funding but also significantly on the knowledge, skills, motivation, and stability of healthcare professionals.

Employee retention in healthcare has become a critical issue globally and in Mongolia. Increasing workload, relatively low salaries, challenging working conditions, psychological stress, and limited social security contribute to workforce instability. In rural areas, the shortage of healthcare professionals and migration to other countries further intensify the problem.

Healthcare professionals carry high responsibility, as their work directly impacts human lives. If employees experience dissatisfaction, high stress, or limited growth opportunities, they are more likely to leave their jobs or migrate. This leads to workforce shortages and negatively impacts healthcare service delivery.

Therefore, identifying and analyzing the factors affecting employee retention is both theoretically and practically important. This study aims to explore these factors and provide recommendations for improving human resource management in healthcare organizations.

Research Objective and Tasks

Objective

To identify the key factors influencing employee retention among healthcare workers.

Tasks

• To study the theoretical background of employee retention
• To identify and classify influencing factors
• To analyze the impact of these factors
• To propose improvement strategies

Literature Review

Sandra K. Collins & Kevin S. Collins (2004) stated that employee retention in healthcare organizations is a critical factor for organizational survival. Many researchers have examined the factors that determine employee retention in hospitals. Collins & Collins (2004) identified it as a key factor for organizational survival, while Fogarty (2014) emphasized job satisfaction as the main influencing factor. Furthermore, a study found that leadership, career growth, and work–life balance are significant determinants. Systematic studies also indicate that multiple factors—such as the work environment, organizational culture, relationships, and career development—collectively influence employee retention.

Employee retention refers to an employee’s willingness and ability to remain in an organization for a long period. It is closely related to several theories:

• Job Satisfaction Theory: Higher job satisfaction increases retention.
• Human Resource Management Theory: Organizational policies and incentives influence employee decisions.
• Maslow’s Hierarchy of Needs: Employees must fulfill physiological, safety, social, and self-actualization needs.
• Herzberg’s Two-Factor Theory: Hygiene factors (salary, conditions) prevent dissatisfaction, while motivators (growth, recognition) enhance retention.

Key Factors Affecting Employee Retention

Working Conditions

Working conditions are one of the most important factors influencing employee satisfaction and retention.

Healthcare workers operate in high-risk environments, including exposure to infectious diseases and hazardous materials. Lack of protective equipment can negatively impact both health and job satisfaction.

Workload and working hours are also critical. Long shifts, night duties, and high patient loads lead to physical and mental exhaustion, contributing to burnout.

Additionally, inadequate medical equipment reduces efficiency and increases frustration. A positive team environment and supportive workplace relationships are essential for reducing stress and improving retention.

Salary and Compensation

Salary is a fundamental factor in employee retention.

• Low salaries lead to financial stress and increase turnover.
• Incentives such as overtime pay, bonuses, and performance-based rewards improve motivation.
• Social benefits (health insurance, housing support, education benefits) enhance job satisfaction.
• Fair and transparent compensation systems are essential.

Global labor market competition also encourages healthcare workers to migrate to countries offering better salaries and conditions.

Professional Development and Training

Continuous learning is essential in healthcare due to rapid technological advancements.

• Regular training programs improve skills and motivation.
• Opportunities for higher education (Master’s, PhD, specialization) support career growth.
• On-the-job training and mentoring enhance practical skills.
• Organizational support for education increases retention.

Employees are more likely to stay in organizations that invest in their professional development.

Workload and Stress

Workload and stress significantly affect retention.

Excessive workload leads to:

• Burnout
• Reduced job satisfaction
• Increased errors
• Higher turnover intention

Healthcare workers, especially nurses and emergency staff, are highly vulnerable due to long hours and high responsibility.

Organizations should:

• Balance workload
• Improve shift scheduling
• Provide psychological support
• Promote rest and recovery

Social and Family Factors

Work-life balance is essential for employee retention.

Long working hours and night shifts negatively affect family life and increase stress. Family support plays a key role in helping employees cope with work pressure.

Social factors such as housing, education, and healthcare access also influence employees’ decisions to stay or leave.

Organizations should implement family-friendly policies and flexible working arrangements.

Leadership and Organizational Culture

Leadership style and organizational culture are critical factors.

Supportive, fair, and transparent leadership increases employee trust and loyalty. Poor management, lack of communication, and unfair evaluation systems lead to dissatisfaction and turnover.

Strong organizational culture fosters teamwork, trust, and psychological safety.

Methodology

This study used a quantitative research approach.

• Research design: Cross-sectional
• Sample: 120 healthcare workers (doctors and nurses)
• Data collection: Standardized questionnaire
• Analysis: SPSS software
  • Descriptive statistics
  • Correlation analysis
  • Regression analysis

Results

The findings indicate:

• Higher workload is associated with increased turnover intention
• Professional development opportunities improve retention
• Supportive leadership increases employee stability

Correlation results:

• Stress ↔ Retention (negative relationship)
• Development ↔ Retention (positive relationship)

Regression analysis identified key predictors:

• Work stress
• Professional development
• Leadership support

Discussion

The findings are consistent with previous studies. Workload and stress negatively affect retention, while development opportunities and organizational support have positive effects.

The results align with Herzberg’s theory, indicating that salary and working conditions alone are insufficient to retain employees. Growth opportunities and recognition are crucial.

Conclusion

This study confirms that employee retention in healthcare is a multifaceted issue influenced by various factors, including working conditions, organizational policies, personal needs, and social environment.

Workload and stress are the strongest negative factors, while professional development and organizational support are key positive factors. Leadership and organizational culture also play a significant role.

To improve retention, healthcare organizations should focus on:

• Optimizing workload distribution
• Enhancing training and development programs
• Providing psychological support
• Strengthening leadership and organizational culture

Implementing these strategies will not only improve employee retention but also enhance the quality and accessibility of healthcare services.