Nurse retention in Europe: why economic evidence matters

Europe faces a health workforce crisis with nurses comprising the largest occupational group affected. International organisations argue that nurse retention should be the priority response. However, Europe lacks economic evidence to inform evidence-based action on retention. A research gap exists with regard to European studies that quantify nurse turnover costs, provide comparative cost data across countries, or evaluate the cost-effectiveness of retention initiatives. Other high-income countries have measured turnover costs, demonstrating both the feasibility of such analysis and the financial magnitude of the problem. Yet these findings cannot be transferred to European health systems due to differences in clinical practice, payment and other system characteristics, nurse skill-mix, and scope-of-practice. This Viewpoint addresses why turnover cost estimates from other regions cannot be applied to European health systems and what European hospital leaders, workforce planners, and policymakers could do with economic evidence they do not currently have. It calls for a European research agenda that prioritises comparative economic evidence on nurse retention to build the investment cases that decision-makers need. Economic evidence alone will not secure retention investments, but it is difficult to make the case for them without it.