Healthcare organizations around the world continue to struggle with employee turnover, particularly among temporary and contract workers. Frequent staff departures increase recruitment and training costs, disrupt teamwork, and may ultimately reduce the quality of patient care. In Indonesia, public hospitals face similar challenges as many non-permanent healthcare employees work under contracts that provide limited long-term job security. The study highlights that maintaining a stable healthcare workforce is becoming increasingly important as hospitals seek to improve service quality and organizational sustainability.
The researchers note that one regional public hospital in Aceh Province experienced considerable fluctuations in turnover among contract employees between 2021 and 2025. These conditions prompted a closer examination of how perceived job insecurity influences employees' intentions to leave and what organizational factors may help reduce that risk.
Survey of 248 Temporary Hospital Employees
The study employed a quantitative survey involving 248 temporary employees selected through simple random sampling from a population of 670 non-permanent workers at a regional public hospital in Banda Aceh.
Participants completed structured questionnaires using a five-point Likert scale. The researchers then analyzed the data using Structural Equation Modeling–Partial Least Squares (SEM-PLS), allowing them to evaluate relationships among job insecurity, job search behavior, job embeddedness, and turnover intention.
Most respondents were women (62.9%), between 25 and 35 years old (56.5%), held diploma-level qualifications (59.3%), and had worked at the hospital for three to five years (41.9%). These characteristics represent a workforce in productive career stages but facing uncertainty regarding future employment.
Job Insecurity Encourages Employees to Look Elsewhere
The findings demonstrate that employees who perceive greater uncertainty about their employment are significantly more likely to search for alternative jobs and develop stronger intentions to leave their current organization.
The study identified several important relationships:
- Job insecurity significantly increases turnover intention.
- Job insecurity strongly encourages employees to actively search for new jobs.
- Active job searching further increases turnover intention.
- Job embeddedness reduces employees' intentions to resign.
- Job search acts as a mediator between job insecurity and turnover intention.
- Job embeddedness weakens the negative effects of job insecurity on turnover intention.
Among all tested relationships, job insecurity had its strongest influence on job search behavior, with a path coefficient of 0.722. The research also found that job insecurity directly increased turnover intention (β = 0.386), while job search itself contributed to employees' intentions to leave (β = 0.231). Overall, the proposed research model explained 71.6% of the variation in turnover intention, indicating that the identified factors provide a strong explanation of why temporary employees consider leaving their jobs.
Strong Organizational Attachment Makes Employees Stay
One of the study's most significant findings concerns job embeddedness, which describes how connected employees feel to their organization through workplace relationships, shared values, and the perceived sacrifices associated with leaving.
Employees with higher levels of job embeddedness were considerably less likely to develop turnover intentions, even when they experienced uncertainty regarding their employment status. Positive relationships with colleagues, supportive work environments, and alignment with organizational values appeared to strengthen employees' willingness to remain in the organization despite challenging conditions.
The research suggests that emotional and social attachment to the workplace serves as a protective factor, reducing the impact of job insecurity on employee retention.
Implications for Hospital Management
The findings provide valuable guidance for healthcare organizations seeking to improve workforce stability.
Rather than relying solely on financial incentives, hospital managers may benefit from implementing strategies that enhance employees' sense of belonging, strengthen workplace relationships, and create clearer career development opportunities. Increasing organizational support, improving communication, and providing greater employment stability could reduce unnecessary turnover among temporary healthcare workers.
Improving job embeddedness may also help hospitals retain experienced staff, reduce recruitment costs, and maintain continuity in patient care. Since healthcare services depend heavily on experienced professionals working collaboratively, retaining skilled employees becomes essential for sustaining service quality.
Contribution to Human Resource Management Research
According to Sausan Tamita Rizky and colleagues from Universitas Syiah Kuala, the study expands existing human resource management literature by combining job search as a mediating variable and job embeddedness as a moderating variable within a single analytical framework. This integrated approach offers a more comprehensive explanation of how psychological perceptions of job insecurity translate into actual intentions to leave an organization while identifying factors that can reduce that risk.
The research also contributes to the application of the Conservation of Resources (COR) Theory, demonstrating how employees attempt to protect valued resources—such as stable employment—when they perceive threats to their careers.
Why the Findings Matter
As many healthcare systems increasingly rely on contract-based employment, understanding the factors behind employee retention has become a strategic priority.
For policymakers, the findings support the development of employment policies that provide greater security for temporary healthcare workers. For hospital administrators, the research emphasizes the importance of fostering supportive organizational cultures alongside competitive employment conditions.
More broadly, the study demonstrates that improving workplace relationships and organizational commitment can be as important as financial compensation in retaining valuable healthcare professionals.
Author Profile
Sausan Tamita Rizky is a researcher from the Faculty of Economics and Business, Universitas Syiah Kuala, Banda Aceh, Indonesia, specializing in Human Resource Management, organizational behavior, and employee retention.
She conducted this research with Muslim Abdul Djali and Fairuzzabadi, who are also affiliated with the Faculty of Economics and Business, Universitas Syiah Kuala. Their research focuses on human resource management, organizational behavior, and workforce sustainability in public sector organizations.
Source
Article Title: The Effect of Job Insecurity on Turnover Intention, Mediated by Job Search and Moderated by Job Embeddedness, Among Non-Permanent Employees in the Public Healthcare Sector
Journal: Formosa Journal of Multidisciplinary Research (FJMR), Vol. 5, No. 6 (2026)
Authors: Sausan Tamita Rizky, Muslim Abdul Djali, Fairuzzabadi
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