Original Research
When eggs in the same basket are apples and oranges: length of stay for public sector allied health professionals in regional, rural and remote southern Queensland: 2010–2021
AUTHORS
Anthony Bruce Fallon1,2 (Non-Indigenous) PhD, Research Officer and Adjunct Research Fellow * 
Clara Walker1,2 MPH, Principal Project Officer and Adjunct Research Fellow
Anna Coghlan3 BSc (Hons), Master's Student
Priya Martin4,5 PhD, Discipline lead and Program Director and Adjunct Associate Professor
Ansmarie Van Erp6,7 PhD, Director and Adjunct Associate Professor
Jessica Elliott8,9 MRes, Lecturer and PhD Candidate
Lee O'Malley10 RN, PhD Candidate
Bahram Sangelaji1 PhD, Research Assistant
Hwee Sin Chong11 MD, Executive Director
AFFILIATIONS
1 Southern Queensland Rural Health, University of Queensland, Brisbane, Qld, Australia
2 Centre for Health Research, University of Southern Queensland, Toowoomba, Qld 4350, Australia
3 The University of Queensland, St Lucia, Qld 4072, Australia
4 Occupational Therapy, School of Health and Medical Sciences, University of Southern Queensland, Toowoomba, Qld 4350, Australia
5 Rural Clinical School, The University of Queensland, Qld, Australia
6 Darling Downs Health, Queensland Country Practice, Brisbane , Qld 4001, Australia
7 School of Health and Medical Sciences, University of Southern Queensland, Toowoomba, Qld 4350, Australia
8 School of Nursing and Midwifery, University of Southern Queensland, Ipswich, Qld 4305, Australia
9 Centre for Health Research, University of Southern Queensland, Ipswich, Qld 4305, Australia
10 School of Nursing and Midwifery, Griffith University, Southport, Qld 4350, Australia
11 Darling Downs Health, Queensland Medical Rural Service, Toowoomba, Qld 4350, Australia
ACCEPTED: 11 February 2026
Early Abstract:
Introduction: Low retention of allied health (AH) professionals remains a major issue in regional, rural and remote areas of Australia. Professions in this 'catch-all' label differ markedly in often fundamental ways. In most workforce research, however, low sample sizes often result in the combining of data from these diverse professions, potentially obscuring differences in employee retention. This study sought to assess employment retention patterns of public sector AH professionals in regional, rural and remote regions of Southern Queensland, Australia, to determine: (a) retention time in location for various AH professions; (b) the impact of geographic location and other available demographic and employment covariates on risk of leaving location; and (c) key exit times.
Methods: A retrospective quantitative longitudinal design used de-identified AH employee records from two public health services from a 12-year observation period (January 2010 - December 2021). The critical time-based variable for survival analysis and Cox Regression of employee retention was years employed in location, with profession and geographic remoteness of work location being primary covariates of interest.
Results: Analysis of records from 1454 AH employees revealed a median retention time of 1.27 years [95% CI, 1.15-1.46]. Those working in anaesthetic technician (HR: 0.45, 95% CI: 0.26-0.77), radiography/sonography/medical imaging (HR: 0.59, 95% CI: 0.45-0.77), pharmacy (HR: 0.61, 95% CI: 0.48-0.78), social work (HR: 0.66, 95% CI: 0.52-0.83), psychology/mental health (HR: 0.68, 95% CI: 0.55-0.86) and other AH positions (HR: 0.81, 95% CI: 0.62-1.07) were less at risk of leaving location than the physiotherapist reference group: Speech pathologists (HR: 0.86, 95% CI: 0.66-1.11), occupational therapists (HR: 0.83, 95% CI: 0.68-1.03) and dieticians (HR: 0.81, 95% CI: 0.62-1.07) were at no greater risk. Those working in rural (HR: 1.61, 95% CI: 1.41-1.84) and remote (HR: 2.16, 95% CI: 1.80-2.61) communities exhibited higher risk of leaving their location than those working in the regional city, with these risks emerging within 3-6 months after starting a position. Type of employment, age when starting employment, and starting paygrade also had small but significant influences on risk of leaving location.
Discussion: Despite lower overall median retention time, possibly partly due to using a location-based time-dependent variable, patterns observed in this study are largely consistent with previous research. Use of a location-based time-dependent variable is advocated for future research: It most closely aligns with costs associated with replacing location-based positions, continuity of care and ultimately patient outcomes. The findings suggest: (a) prioritisation of interventions targeted towards AH professions at highest risk of leaving location; and (b) delivery of interventions in the first 12 months after starting employment in location. Cosgrave’s Whole-of-Person Retention Improvement model is a potential framework for tailoring bespoke interventions to maximise AHP retention.
Conclusions: The 'eggs' in the AH basket are indeed 'apples and oranges' when it comes to length of stay in location across different AH professions and work locations. Employees in four professions (physiotherapy, speech pathology, occupational therapy and dietetics) are at enhanced retention risk when compared with other AH professions, as are those working in rural and remote areas, particularly within 6 months of commencing a role in location. These findings have important implications as to where and when interventions targeting retention might be most effective.
Keywords: allied health occupations, employee turnover, geographic distribution, health workforce, nutrition, occupational therapy, physical therapy, speech-language pathology, survival analysis, rural health.