The healthcare sector in Taiwan is currently facing a critical challenge due to a rising attrition rate among nurses and physicians. Despite an advanced healthcare infrastructure, low wages, heavy workloads and limited professional growth opportunities have led many healthcare professionals to seek alternative employment in the private secto or abroad. With Taiwan's rapidly ageing population exacerbating the demand for healthcare services, the need for effective retention strategies is more urgent than ever. A recent study has proposed a novel data-driven, multicriteria decision-making model to support policymakers and hospital administrators in designing targeted, evidence-based workforce retention plans.
The Workforce Retention Crisis in Taiwan
Taiwan’s public healthcare system, although efficient and comprehensive, places a substantial burden on its workforce. The frequency of patient visits, high stress levels and night shifts contribute to dissatisfaction among healthcare staff. The COVID-19 pandemic intensified these issues, leading to a 40% decline in registered nurses and growing reliance on overseas employment opportunities. Younger professionals, especially women in their early thirties, are particularly prone to leaving due to family responsibilities and career dissatisfaction.
Policy efforts, such as the 2023 Cabinet-approved incentive programme, have attempted to mitigate this trend by offering improved nurse-to-patient ratios and financial bonuses. However, such interventions may unintentionally encourage further migration to higher-paying private roles, thereby undermining the public system. As a result, healthcare administrators must pursue a more nuanced approach that considers the diverse needs and preferences of various employee groups.
A Multicriteria Satisfaction Index Approach
To address the complexity of workforce retention, researchers developed a four-phase, data-driven methodology grounded in multicriteria decision-making. This approach introduces a satisfaction index capable of ranking employee groups based on subjective evaluations and expert-derived weightings.
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The first phase involves identifying and clustering key job satisfaction criteria into three dimensions: working environment, organisational context and future development. These dimensions encompass factors such as salary, leadership style, respect at work and access to career progression.
In the second phase, data is collected using two separate questionnaires. The first gathers demographic details and subjective ratings from healthcare workers on the identified criteria, allowing respondents to be sorted into four main age-based groups and subdivided according to experience-based satisfaction scores. The second questionnaire captures expert judgments on the relative importance of the criteria, enabling the construction of weighted evaluation matrices.
The third phase applies an adjusted Analytic Hierarchy Process (AHP) to determine the relative importance of both individual criteria and their respective clusters. The final phase uses these weightings to compute satisfaction indices for each employee group, providing a detailed, quantitative assessment of workforce contentment across the age spectrum.
Insights from the Taiwanese Case Study
The methodology was implemented in three healthcare institutions in Northern Taiwan, where 99 respondents completed the first questionnaire. They were categorised into four age-based groups and five subgroups based on their average satisfaction ratings. Experts from the Institute of Health and Welfare Policy at NYCU completed the second questionnaire to establish the priority weights for each criterion.
The resulting satisfaction indices revealed that employees aged 36–40 (main group III) reported the highest satisfaction, potentially due to greater career stability and personal circumstances. Conversely, those aged 31–35 (main group II) were the least satisfied, particularly in the dimension of future development, which includes training, promotion and career support. These insights suggest that retention efforts should focus more intensively on professional development opportunities for mid-career staff to align with their aspirations and life stage challenges.
The study offers a novel, rigorous framework for assessing healthcare employee satisfaction and tailoring retention strategies accordingly. By capturing nuanced worker preferences and prioritising interventions based on data-driven insights, hospital managers and policy-makers can more effectively address the diverse needs of their workforce. Beyond the immediate application in Taiwan, the model is adaptable to other employment sectors and geographic contexts. It also paves the way for broader integration into Quality Management systems, enhancing the ability of healthcare institutions to evaluate and continuously improve their workforce retention strategies.
Source: Healthcare Analytics
Image Credit: iStock
