Why they stay or leave: How emotional intelligence and organizational culture shape commitment in healthcare

Turnover intention among healthcare professionals threatens the stability of health systems, especially in countries such as Bosnia and Herzegovina with workforce shortages. Drawing on the job demands-resources framework, this study examines how emotional intelligence, perceived managerial competence, and ethical culture relate to burnout, affective commitment, and turnover intention. A cross-sectional survey was conducted with 195 physicians and nurses in public and private hospitals. Data were analyzed using confirmatory factor analysis and structural equation modeling. Emotional intelligence was positively related to managerial competence and ethical culture, which in turn predicted lower burnout and higher affective commitment. Burnout strongly increased turnover intention, whereas managerial competence and affective commitment reduced it. Emotional intelligence did not directly predict turnover intention but showed significant indirect effects through managerial competence and affective commitment. Findings extend retention research in under-studied health systems, but despite these contributions, the study is limited by its cross-sectional, self-report design, single-country, non-probability sample, and potential common-method bias.