In human resource management, turnover intention is a significant problem, especially in the healthcare industry, including hospitals (Lay & Masingboon, 2025). High turnover intention has the potential to reduce service quality, increase the workload of existing personnel, and disrupt the overall stability of the organization, in addition to increasing recruitment and training costs (Mobley, 1977). Because healthcare demands constant competence, efficient work collaboration, and the best possible patient care, workforce sustainability is crucial in hospital organizations.

Various studies show that turnover intention among health workers is still relatively high in various countries (Fan et al., 2026; Nasonenko et al., 2026; Xiaofang et al., 2026). Meta-analysis conducted by (Lay & Masingboon, 2025) found that the prevalence of new nurse turnover intention ranged from 6% to 61% in countries such as Canada, the United Kingdom, the United States, Korea, the Philippines, Turkey, China, and Finland. A similar situation also occurred in Indonesia, where several hospitals reported high levels of healthcare worker turnover, exceeding the organization's normal limits (Firmansyah et al., 2023). The high intention to leave indicates work pressure, dissatisfaction, and instability in working conditions experienced by employees.

One regional general hospital in Aceh Province also experienced employee turnover, particularly among non-permanent staff. Contract worker turnover rates varied significantly between 2021 and 2025, according to hospital data. Turnover rates rose sharply to 95.34% in 2023 from 49.07% in 2022. While declining to 12.82% in 2024, turnover rates increased to 19.85% in 2025. This situation indicates that the hospital organization continues to face significant challenges in maintaining workforce stability and high-quality healthcare services due to non-permanent employee turnover.

Job instability is one of the reasons often associated with turnover intention. Job insecurity is a person's feeling of perceived risk to their job and their powerlessness in facing that risk (Greenhalgh & Rosenblatt, 1984). Workers who experience job insecurity often experience psychological stress and a tendency to leave the company because they are worried about their future employment (De Witte, 2005). Job insecurity, career development opportunities, and income stability make this scenario increasingly relevant for contract workers.

According to previous studies, turnover intention is positively influenced by job instability (Sverke et al., 2002). workers who believe their jobs are insecure are more likely to look for other jobs that they believe are more stable and promising (De Witte, 2005; Greenhalgh & Rosenblatt, 1984). High service expectations, work pressure, and ambiguous job status can all contribute to feelings of job insecurity among healthcare workers. As a result, companies risk losing skilled and experienced employees.

People typically employ a variety of adaptive tactics to protect their resources when facing job insecurity. According to Conservation of Resources (COR), people will work to acquire, preserve, and protect resources they value, such as stable employment and careers (Hobfoll, 1989). According to this view, job instability can encourage job search behavior because people seek more secure employment options, in addition to having a direct impact on turnover intention. Job search behavior is the act of someone seeking information and other job opportunities outside their current company. (Blau, 1994) Finding job openings, exploring career options, and applying for jobs are some examples of this behavior. People who are actively job searching are more likely to leave their company because they start considering other positions that better match their requirements and expectations. According to previous research, job insecurity affects job search and ultimately increases turnover intention (Yüce Selvi & Sümer, 2021).

However, not everyone who is looking for a new job and feels insecure in their current position has a strong desire to leave the company. In some cases, workers decide to stay because they have a strong sense of loyalty to the company. The level of job embeddedness and its environment through social connections, value congruence, and the perceived costs of leaving the job are explained by the concept of job embeddedness (Mitchell et al., 2001). When making the decision to leave a company, workers with high levels of job embeddedness typically consider a variety of social, psychological, and financial consequences.

Research by (Mitchell et al., 2001; Lee et al., 2004) Research shows that job embeddedness is a significant factor in reducing turnover intention and weakening the influence of various negative work conditions on turnover intention. In the hospital context, employee engagement with coworkers, the work environment, and their profession can be a significant factor encouraging employees to remain in the workforce despite facing work pressure or job insecurity. Thus, job embeddedness is seen as a protective factor that can mitigate the negative impact of job insecurity and job search on turnover intention.

Job insecurity, job search, job embeddedness, and turnover intention remain under-researched in Indonesia. Most previous studies have only examined the direct relationship between job insecurity and turnover intention, not the mediating role of job search behavior and job embeddedness. Although non-permanent staff are more vulnerable to job insecurity than permanent employees, research on them in government hospitals is still scarce.

This study has several unique features that warrant further research. First, by establishing job search as a mediating variable and job embeddedness as a moderating variable, this study simultaneously combines mediation and moderation models within a single research framework. Second, this study focuses on non-permanent workers in government hospitals, an industry in which turnover intention has not been widely researched. Third, the Conservation of Resources (COR) Theory approach is used in this study to describe the behavioral and psychological strategies employed by workers to cope with job instability. Thus, the purpose of this study is to examine how job insecurity influences turnover intention among non-permanent employees in government hospitals in Aceh Province, mediated by job search and moderated by job embeddedness.

The tendency of a person to intentionally and freely leave his organization is known as turnover intention (Mobley, 1977). Turnover intention is a serious problem in the healthcare industry because it can reduce organizational stability, increase recruitment and training costs, and disrupt service quality. Turnover intention is influenced by several factors, such as job instability, job search, and job embeddedness.

According to the Conservation of Resources (COR) Theory, people tend to conserve and protect their current resources, such as career security, income, and job stability (Hobfoll, 1989). When people feel their jobs are in jeopardy, they experience psychological distress and try to find other jobs to reduce the possibility of losing resources. Consequently, job insecurity is thought to have a significant impact on job search and turnover intentions.

Job Insecurity is an individual's perception of threats to the continuity of their employment and the powerlessness they feel in the face of these threats (Greenhalgh & Rosenblatt, 1984). High levels of job insecurity increase the likelihood of employees leaving the company because it makes them worried about their career prospects. Previous research has shown that job insecurity has a positive effect on turnover intention (De Witte, 2005; Sverke et al., 2002).

H1: Job insecurity has a positive effect on turnover intention.

H2: Job insecurity has a positive effect on job search.

H3: Job search has a positive effect on turnover intention.

H4: Job embeddedness has a negative effect on turnover intention.

H5: Job search mediates the effect of job insecurity on turnover intention.

H6: Job embeddedness moderates the effect of job insecurity on turnover intention.

H7: Job embeddedness moderates the effect of job search on turnover intention.

This exploratory quantitative study analyzes how job embeddedness influences turnover intention in a regional public hospital in Aceh, which employs temporary workers. Job embeddedness and job search modify this influence. The quantitative approach uses statistical analysis and numerical data to objectively investigate the relationships between variables. The investigation was conducted at a regional public hospital in Banda Aceh, Aceh. The survey included 670 temporary workers. Probability sampling and simple random selection ensured that all members of the population had an equal chance of being selected as respondents. The study had 248 participants, as shown in the table (Sekaran & Bougie, 2016).

The study data was obtained through a Google Forms poll. The study tool used a five-point Likert scale, with 1 meaning "strongly disagree" and 5 meaning "strongly agree." Job insecurity, turnover intention, job search, and job embeddedness were adapted from (De Witte, 2005), (Blau, 1994), (Mitchell et al., 2001). SmartPLS software was used to analyze the data using Structural Equation Modeling (SEM) based on Partial Least Squares (PLS). This study tested the model internally and externally. Convergent validity, discriminant validity, and construct reliability testing using factor loading values, AVE, Composite Reliability, and Cronbach's Alpha were external model tests. To assess the relationship between factors, the internal model was tested using path coefficients, R-squared, predictive relevance (Q2), and bootstrapping.

The research assumptions and structural model were tested using SmartPLS and PLS-SEM software. The measurement model (outer model) was assessed for instrument validity and reliability, and the structural model (inner model) was bootstrapped with 5,000 random samples to identify the hypothesized relationships.

Table 1. Respondent Characteristics (Summary: 248 participants; 156 Female/62.90%, 92 Male/37.10%; Age majority 25-35; Education majority Diploma; Work period majority 3-5 years).

The test results confirmed the accuracy of all concepts, with factor loadings above 0.70 and AVE values above 0.50. The reliability of the research instrument was confirmed by Composite Reliability and Cronbach's Alpha values exceeding 0.70 for all variables.

Based on the R-squared value, 52.1% of the job search variable can be explained by job instability. Meanwhile, job insecurity, job search, and job embeddedness explain 71.6% of turnover intention, with variables outside the research model influencing the remaining portion.

According to research, job insecurity has a positive impact on turnover intention. The results show that temporary workers are more likely to leave an organization when they feel insecure in their jobs. Research findings indicate that job insecurity increases job search. This implies that workers experiencing job insecurity are more likely to actively seek other employment. Research findings indicate that job search positively impacts turnover intention. Employees' likelihood of leaving a company increases with their level of job search activity. Research findings indicate that job embeddedness negatively impacts turnover intention. This implies that workers who are highly attached to their organization typically have fewer plans to leave. Research shows that job search mediates the relationship between job insecurity and turnover intention. The results of the study indicate that job embeddedness reduces the impact of job insecurity on turnover intention. People who are highly engaged in their jobs tend to remain with the company even when their employment is unstable because they have strong emotional and social ties to the company.

This study examines the relationship between job insecurity and work planning among temporary workers at a regional public hospital in Aceh Province. This relationship is influenced by job search and job loyalty. First, job insecurity increases turnover intention. Second, job search methods increase job insecurity. Third, turnover intention positively impacts job search behavior. Fourth, turnover intention is negatively influenced by job embeddedness. Fifth, job search links job insecurity and turnover intention. The results also show that job embeddedness influences the relationship between job insecurity and turnover intention. Specifically focusing on job turnover behavior in the healthcare industry, this study offers theoretical contributions to the advancement of human resource management research.

There are several limitations to this study. First, the findings cannot be broadly applied to the entire Indonesian healthcare system because the study was limited to one government hospital in Aceh Province. Second, the study only describes conditions within a specific time period because it used a cross-sectional method. Third, there is the possibility of respondent bias because the study data was collected through self-report questionnaires. To obtain more representative results, it is recommended that the research sample be expanded to include private hospitals and other healthcare facilities.