TY - JOUR
T1 - Physician emigration
T2 - should they stay or should they go? A policy analysis
AU - Amorim-Lopes, Mário
AU - Almeida, Álvaro
AU - Almada-Lobo, Bernardo
N1 - Funding Information:
The authors would like to thank the three anonymous reviewers for their very relevant contributions. The work benefited immensely from their remarks. Also, this work is financed by the ERDF European Regional Development Fund through the Operational Programme for Competitiveness and Internationalisation - COMPETE 2020 Programme and by National Funds through the Portuguese funding agency, FCT - Fundação para a Ciência e a Tecnologia within project POCI-01-0145-FEDER-016738, and also by the PhD research Grant SFRH/BD/102853/2014 awarded by FCT.
Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Physician emigration can either function as an escape valve to help the health labour market clear from a supply surplus, or aggravate the problem further in case of a shortage. Either way, policy-makers should be particularly aware and devise policies to minimize the occurrence of an imbalance in the physician workforce, which may require physician retention policies if barriers to entry and other market rigidities can not be removed. To this purpose we have developed an agent-based computational economics model to analyse physician emigration, and have used it to study the impact of potential short- and long-term retention policies. As a real case study we have calibrated it with data from Portugal, which features a very particular health system with many rigidities. Results show that all policies are capable of increasing the workforce size, but not all reduce emigration. Also, the effect of return migration is non-negligible, and may substantially offset the impact on the workforce size. Furthermore, the welfare impact of the policies varies considerably. Whether policies to retain physicians should be enacted or whether policy makers should let physicians go will depend on the type of imbalance present in the health system.
AB - Physician emigration can either function as an escape valve to help the health labour market clear from a supply surplus, or aggravate the problem further in case of a shortage. Either way, policy-makers should be particularly aware and devise policies to minimize the occurrence of an imbalance in the physician workforce, which may require physician retention policies if barriers to entry and other market rigidities can not be removed. To this purpose we have developed an agent-based computational economics model to analyse physician emigration, and have used it to study the impact of potential short- and long-term retention policies. As a real case study we have calibrated it with data from Portugal, which features a very particular health system with many rigidities. Results show that all policies are capable of increasing the workforce size, but not all reduce emigration. Also, the effect of return migration is non-negligible, and may substantially offset the impact on the workforce size. Furthermore, the welfare impact of the policies varies considerably. Whether policies to retain physicians should be enacted or whether policy makers should let physicians go will depend on the type of imbalance present in the health system.
KW - Agent-based computational economics
KW - Health policy
KW - Healthcare workforce planning
KW - International medical graduates
KW - International migration
KW - Physician migration
UR - http://www.scopus.com/inward/record.url?scp=85053785153&partnerID=8YFLogxK
U2 - 10.1007/s10614-018-9854-1
DO - 10.1007/s10614-018-9854-1
M3 - Article
AN - SCOPUS:85053785153
SN - 0927-7099
VL - 54
SP - 905
EP - 931
JO - Computational Economics
JF - Computational Economics
IS - 3
ER -