Overview of the prevalence of job satisfaction and turnover intention among emergency medical services personnel: a meta-analysis

Abstract

Background Emergency medical services (EMS) personnel, including paramedics, emergency medical technicians (EMTs), and firefighters are subjected to substantial occupational stressors that diminish job satisfaction and increase turnover rate, ultimately affecting efficient delivery of pre-hospital emergency care. Therefore, we performed the first meta-analysis to determine the prevalence of job satisfaction and turnover intention among EMS personnel, including paramedics, emergency medical technicians (EMTs), and firefighters. Methods We comprehensively searched Web of Science, PubMed, Cochrane Library, Embase, and EBSCOhost until March 2025. The pooled prevalence of job satisfaction and turnover intention was analysed using the Freeman-Tukey double-arcsine transformation model in R software. Cochran’s Q and I2 statistics assessed heterogeneity and subgroup analysis explored moderator variables. Results A total of 25 studies with 59 562 EMS personnel were included. The pooled prevalence of job satisfaction was 63% (95% confidence interval (CI) = 53%, 72%), with estimates of 71% for EMTs, 62% for firefighters, and 54% for paramedics. Job satisfaction was 56% during the COVID-19 pandemic and 65% in the pre-pandemic period. The pooled prevalence of turnover intention was 29% (95% CI = 24%, 36%), with estimates of 28% for paramedics, 22% for EMTs, and 17% for firefighters. Turnover intention was 34% during COVID-19 pandemic and 27% in the pre-pandemic period. Conclusions Approximately, 63% of EMS personnel report job satisfaction, while 29% express intent to leave the profession. Mental health support, workload management, and professional development opportunities should be promoted among EMS personnel to further enhance job satisfaction and mitigate turnover intention.