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Research Data Of Medical Migration In Hungary Medical Doctors Evaluation, Lessons, Conclusions

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Title: Research Data Of Medical Migration In Hungary Medical Doctors Evaluation, Lessons, Conclusions


1
Research Data Of Medical Migration In Hungary
(Medical Doctors) Evaluation, Lessons,
Conclusions
A Call to Action Ensuring Global Human Resources
for HealthInternational Health Workforce
Conference Track I. The Health Worker a
National and Global Profile Panel Data
Collection Methods and Limitations Are Data
Sets Evidence-Based?
  • Dr. Miklós Szócska, Dr. Edit Eke,
  • Edmond Girasek, Dr. Emília Gaál

2
Motivation for the study
  • 2003 Anecdotal evidence on shortages and
    emerging EU brain drain - data is important to
    see trends (observatory function)
  • Important set of values involved (sustainability
    of services, equity, accessibility of care) -
    conflicting EU values of free migration and
    equity
  • Potential to see policy in action design
    intervention strategy on the results of the study
  • Economic consequences - magnitude
  • Sensitivity of the issue high stakes in
    politics, media
  • Personal motivation
  • Understanding the force field of migration helps
    us to know more on the workforce challenges in
    health care unique perspective

3
Critical sustainability conditions
  • The study made us understand that simply the
    demography and the migration trends of the
    medical workforce in Hungary will question the
    sustainability of the present care provision
    structures and the future of our training system.

4
Salary, Benefits Incentive Environment
Quality of surrounding infrastructure
Location
Amount and burden of work
Tension between skills and requirements
Filter of perception
Professional assumptions
Professional opportunities
The situation of health care human resources

We are special!
Exposure To Market Forces

Psychological tensions at work (patient relations)
Surrounding Organisation Hierarchy vs. teamwork

Psychological tensions in society (comparisons)
5
(No Transcript)
6
Number and year of filled questionnaires from
2004 to February 2007
7
Main results to date I.
  • Migration potential (average range) 60-70
  • Migration activity active steps (average
    range) 10
  • Main target regions
  • English speaking EU 2. German speaking EU
    3.Nordic countries
  • Top specialties (Data of the Office of Health
    Administration and Procedures OHAP)
  • 2004 anaesthesiology and intensive therapy,
    orthopaedics, family medicine, surgery
  • 2005 family medicine, anaesthesiology and
    intensive therapy, surgery, internal medicine
  • 2006 anaesthesiology and intensive therapy
    family medicine, radiology, surgery, psychiatry

8
Main results to date II.
  • Magnitude of MD-s asking for necessary
    certification to work abroad at OHAP 500-600/
    year
  • Magnitude of registered Hungarian MDs at GMC in
    the first 1.5 years of Hungarian EU membership
  • 360-390 (cca. 7.5 billion HUF cca. 28 million
    Euro loss in direct costs of medical education)
  • Same magnitude in actives and registered
    doctors shows we are starting to hit the real
    dynamics
  • Longitudinal study on the dynamics

9
FORCE FIELD OF MIGRATION Why they want to
leave? Why they want to stay?
  • What drives the high migration potential
  • Payment, financial incentives, better living and
    working conditions, quality of life
  • Professional development and opportunities
  • Respect and prestige of the profession
  • Proficiency in a foreign language
  • What main factors influence those who want to
    stay? Potential retention drivers
  • Love for the home country
  • Love and affection for family and friends
  • Use of mother tongue in work
  • Responsibility for Hungarian patients and health
    care

10
FORCE FIELD OF MIGRATION Why they want to leave?
Why they want to stay? (Average values in a
range of five, where 1 absolutely not, 5
mainly) Residents, General Medical Doctors n
131, 2006 n150, 2007
  • Motivation factors to go
  • Motivation factors to stay

11
Age distribution of actively working MDs in
Hungary (2005)(source Hungarian Medical
Association)
12
Most frequent specialties among certification
applications (OHAP 2006) compared to the data
on shortage of those medical specialties in
Hungary(Yearbook of Health Statistics, 2005)
13
Intention to work abroad Distribution of the
critical and/or needed specialties
(residents, n 823, General Medical Doctors, 665
(80,8) on their first year of residency)
14
Distribution of the critical and/or needed
specialties in the latest sample of resident
doctors( January 2007) (residents, n 150,
General Medical Doctors) compared with the
proposed training cohort of those specialties
15
The residents perceptions about conditions in
the target countrylatest sample of resident
doctors ( January 2007) (residents, n 150,
General Medical Doctors n99 intends to work
abroad)
  • 63,4 of the respondents think that their living
    conditions will be much better
  • 88 think that the working conditions are better
    or much better
  • 63 think that professional possibilities will be
    better or much better
  • 31,9 think that the conditions of scientific
    work are more favourable
  • 77 expect to get better or much better social
    respect and prestige abroad
  • 53,3 consider carrier options similar to the
    ones at home

16
The residents perceptions about conditions in
the target countrylatest sample of resident
doctors ( January 2007) (residents, n 150,
General Medical Doctors n99 intends to work
abroad)1 much worse, than at home 5 much
better than at home
17
Hungarian medical residents expectations for
reasonable salary (net salary/ month)
(Residents, January 2007, n 150)
  • 56,6-a consider 200 300 000 HUF salary ( cc.
    805- 1210 Euro) for MDs at the first 2 years of
    beginning of their carrier
  • 43,5 think 300 400 000 HUF (cc. 1210 1610
    Euro) , 24,5 consider 400 500 000 HUF ( cc.
    1610 2020 Euro for MDs after residency stage,
    but before becoming specialists (that takes up to
    5-7 years after graduation)
  • 32,2 consider net monthly payment above 500 000
    HUF (cc. 2020 Euro), and 34,3 consider between
    300-400 000 HUF (cc. 1210 1610 Euro) for young
    specialists

18
Reasonable Financial expectations (Residents,
January 2007, n 150)
19
Summary points
  • To cause disturbances in the system we do not
    need en mass migration, but scarcity at
    critical points
  • The business of the century inequity
    enterprise
  • The role of professional organisations in Hungary
  • Politics, media and migration in Hungary
  • A need for a human resources strategy on the
    national and EU level

20
Call for interventions
  • Local policies for improving living and career
    conditions for medical professionals
  • Provoke EU debates on value conflict and promote
    ethical frameworks for recruitment
  • Set the vales of the training system according to
    retention drivers
  • Elaborate international exchange schemes that
    promote retention on the long run
  • Use evidence to convince decision makers to
    compensate and support action in donor countries

21
Next to dos in our project
  • Fine tuning and expanding our data collection
    system (including nurses)
  • International comparisons and observatory
    function
  • FP7 priority
  • Publications
  • More active participation in public debates and
    public actions both national and international
    level
  • Hungarian health workforce crisis workshop series
    started
  • What about it on EU level?
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