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2005, 530 hospital doctors, 340 dental practitioners, 950 nurses and 410 nursing auxiliaries and assistants were registered in the Worker Registration Scheme as coming from the new EU member states (Dumont and Zurn, 2007). García Perez et al. (2007) point out that according to the information available for emigration in recent years does not indicate an effect of the EU enlargement in the exodous of doctors from new member states to Norway, France or Germany. We can also measure outflows of health professionals based on the intention to leave which was not as large as anticipated before accession. Outflows have not exceeded the 3% of domestic workforce. Although this intention to leave data should be interpreted with care and might also differ greatly from the actual outflows. The latest WHO report shows that net winners of the enlargement have been predominantly those in the EU 15. For instance, France experienced a higher increase in the number of doctors coming from Romania. Spain and also the United Kingdom report important increases in the inflows of doctors from Poland and Romania. The main effect of the enlargement was to reinforce the inflows from Eastern and Central EU member states towards western parts of the EU. Nevertheless, it is very soon to draw conclusions on the effects of EU enlargement. Recent data from Estonia, Hungary (for the years 2009 and 2010) reveal a new increase in outflows due to the economic recession. I.3.4 Motives to immigrate: Pull and push factors The motives for migrating are often characterized as “push” and “pull factors”. Buchan et al. (2003) summarizes some of the possible main push and pull factors related to health workers (see Table 2). Table I.3.4.1: Main “pull” and “push” factors in migration and international recruitment of health workers Push factors Pull factors Low pay Higher pay Poor working conditions Opportunities for remittances Lack of resources Better working conditions Limited career opportunities Career opportunities Limited educational opportunities Better resourced health systems Provision of post basic education ! ''!
Specific factors Impact of HIV/AIDS Economic instability Unstable work environment Political stability Travel opportunities Aid work One of the main motivations to migrate is income. Some surveys reveal that income was found to be one of the key motivations for health professionals in Estonia, Poland, Romania, and Slovakia. For instance, wage differentials motivate Romanian health professionals to work up in countries where they can earn up to three times more. Also, outflows of medical doctors to Spain dropped in Spain in the mid and late 200s when salary levels rose. Gathering data on remuneration levels is quite difficult because countries collect data based on different sources covering different categories of physicians, and often do not include all income sources. Data on remuneration refers to GPs. The remuneration of GPs ranges from 1.4 times the average wage of all workers in Hungary, to 4.2 times in UK. In all countries, the remuneration of GPs is lower than that of specialists (OECD, 2009). The other most cited motivation is the working conditions, covering elements such as the working environment, terms of employment, working relations. For instance, better working hours is one of the main motivations for Austrian doctors to move to Germany. In 1990s, job insecurity and temporary contracts drove Spanish health professionals to search for a job in Portugal. The latest report about EU (WHO, 2011) indicates that salaries and working conditions were expected to attract medical doctors to some European countries. Nevertheless, these inflows were lower than one might expect due to labor market restrictions in several EU 15 member states. This report also mentions that as an important incentive to migrate is a perception of better salaries and opportunities. Lastly, the possibilities of professional and career advancement are one of the key motivations for Finnish doctors to work abroad. Austrian doctors are attracted to Germany for the absence of waiting times for training places. ! '(!
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F E M I S E R E S E A R C H P R O G
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What Can Be Learnt from the New Eco
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AMGA: American Medical Group Associ
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USA: United State of America WB: Wo
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medical doctors are then free to en
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elate to quality research and educa
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This may concern also EU countries
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discussed both in theory and practi
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EU are then described and discussed
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specialties. This study shows that
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with this trade. Special arrangemen
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into the developed countries; where
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them as follow: Cross-border delive
Page 27 and 28: In this regard, the EU is suggestin
Page 29 and 30: Given the importance of health care
Page 31 and 32: Serbia. Low wages, poor working con
Page 33 and 34: • How does tertiary education wit
Page 35 and 36: Driouchi & Kadiri (2010) are promis
Page 37 and 38: annual living costs per student. Th
Page 39 and 40: Lithuania 4.12 4.15 4.01 4.03 3.97
Page 41 and 42: Egypt 67.57 68.86 70.17 71.52 72.89
Page 43 and 44: observed externally from developing
Page 45 and 46: Relative Wages : MIN MENA / By comp
Page 47 and 48: No future, Heavy workload, to save
Page 49 and 50: one-year qualification apprenticesh
Page 51 and 52: Other European Countries Austria 4
Page 53 and 54: one medical university and studies
Page 55 and 56: includes a three-year vocational tr
Page 57 and 58: has 18 medical universities and stu
Page 59 and 60: général du Gouvernement to gradua
Page 61 and 62: of Medical Science, Bachelor of Med
Page 63 and 64: Egypt Iran 29463 31445 32134 25990
Page 65 and 66: major policies and strategies relat
Page 67 and 68: The aim of this sub-part is to prov
Page 69 and 70: • What is the role of mobility of
Page 71 and 72: Commonwealth of Independent states
Page 73 and 74: Dodani and LaPorte (2005) suggest t
Page 75 and 76: In regards to the mobility of Europ
Page 77: The general conclusions of these th
Page 81 and 82: Portugal X X Romania X X X Russian
Page 83 and 84: Germany Italy Spain Lithuania Slova
Page 85 and 86: Italy (2%) and Russia (4) in 2008 (
Page 87 and 88: theory assumes perfect transferabil
Page 89 and 90: The data available suggest potentia
Page 91 and 92: This chapter deals with the migrati
Page 93 and 94: networks and on the major channels
Page 95 and 96: assumed here that emigration decisi
Page 97 and 98: Increases (respectively decreases)
Page 99 and 100: Figure II.1.2: The shape of H as a
Page 101 and 102: The optimal emigration rate that ca
Page 103 and 104: Figure II.1.4: Effects of the Level
Page 105 and 106: empirical investigation focuses on
Page 107 and 108: Table II.1.3.1: Country annual tren
Page 109 and 110: Table II.1.3.2: Country annual tren
Page 111 and 112: ! ! C/D>)! 01::! 0103! 5881::7! E#%
Page 113 and 114: "#$%&'!()*)+!Eurostat Database Abou
Page 115 and 116: Using these parameter estimates, co
Page 117 and 118: different websites for different co
Page 119 and 120: the theoretical values of the relat
Page 121 and 122: p-value 0.33 0.03 t test 0.99 2.25
Page 123 and 124: The following set of graphs are the
Page 125 and 126: The countries with higher number of
Page 127 and 128: Turkey (m*=0.41, m**=0.77) Yemen (m
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periods but should be concerned abo
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health report “Comptes Nationaux
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In accordance with the health insur
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95 adults >15 years old per 100000
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To achieve progress in the health s
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The external problems comprise (1)
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first four hospital universities ex
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monitoring trends and economic fact
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Other support staff 6300 2.11 2004
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areas, the case of doctors who reti
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areas of Morocco. It is computed ye
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political instability, economic dep
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1. Gender VS Intention to Migrate A
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salaries differs according to the w
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Results The results are given below
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These results suggest that the numb
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Finally, the questionnaire records
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The past decades have witnessed an
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changed the notion of space, where
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implications on health, Huynen et a
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Figure III.1.3: Social stratificati
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Lee et al., (2007) primarily focus
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However, Collins (203) does recogni
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America. In Africa, where there are
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physicians from Liberia practice in
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Figure III.1.7: Migrant care worker
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espectively. An interesting particu
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Table III.1.5: Supply of foreign (-
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Table III.1.6: Health care wages in
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Figure II.1.11: Factors affecting h
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Figure III.1.12: Factors contributi
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Table III.1.10: International Quali
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health as integral to wellbeing thr
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III.2.1 Need for A cooperative Fram
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graduate spends of certain number o
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III.2.2 Migration of Medical Doctor
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The convexity condition is simply a
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• A payoff vector (ai)i S is said
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III.2.2.2 Discussion and Public Pol
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Europe. Second, in the North Africa
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In the short run, the country of or
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great incentive for medical student
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system, and therefore to the rest o
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MENA countries could be moving to p
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of their medical school. The other
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Beine, M., Docquier, F. & Rapoport,
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German Medical Association.(2011).
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World Bank Database, 2007. World Ba
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http://gse.buffalo.edu/org/inthighe
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Berland, Y. (2002). Demographie des
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Gericke, C.A. (2006). Finance healt
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Salehi-Isfahani, D., Tunali, I., As
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Beine, M., Docquier, F. & Rapoport,
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Docquier, F., Lohest, O. & Marfouk,
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Labdelaoui, H. (2010). Les dimensio
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Stark, O. (1991), The Migration of
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WHO - World Health Organization (20
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Linacre, S. (2007). “Migration: p
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Challenging Inequities in Health: F
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Mullan, F. (2007). Doctors and Socc
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Vujicic M, Zurn P, Diallo K, Dal Po
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Collins, T. (2003). Globalization,
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Kana, M.A., (2009). From Brain Drai
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Sagoe, K. (2004). Using the Diaspor
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Sub-part II.1: Appendix I Appendice
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means that So if , then: > which is
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A, B,C>0 and , , Then Demo 5: Sign
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t test 3.21788138 1.86856175 3.1713
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Lithuania Years m Relative wage H/H
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Romania Years m Relative wage H/H0
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MENA Countries Risk Neutral Model C
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Tunisia Turkey 1993 0.1781 2.50 1.9
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Syria Tunisia Turkey Yemen Stand.de
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Morocco Syria Tunisia t-stat (theor
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Risk aversion model summary table C
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Table II-2-1.2: Projections of the
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Observations 5 Coefficients Erreur-
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Figure 4: Age distribution within r
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Figure 11: Migration conditions dis
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! "(&!
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! "((!
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! ")+!
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