Physician shortages in rural Vietnam: Using a labor market approach to inform policy

Vujicic, Marko; Shengelia, Bakhuti; Alfano, Marco; Thu, Ha Bui

doi:10.1016/j.socscimed.2011.06.010

Cited by 52 publications

(68 citation statements)

References 16 publications

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“…These difference is contributed to the child boring and maternity leaves of women (5). In addition, evidence showed that in a country like Iran female physicians prefer stay at home to work in deprived regions (25) similar to Vujicic findings in Philippines in 2011 (9). In this study, being married had a positive relationship with the proportion of working.…”

Section: Discussionsupporting

confidence: 73%

Physician Labor Participation and Unemployment Rate in Iran

2015

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Background:The behavior of physicians after graduating from universities is very important for policymakers. They want to follow these behaviors to find what happened to physicians after graduation. Increasing in physician labor participation rate and an efficient distribution of them by gender and geographical concerns are crucial decisions of policymakers. Objectives: This study aimed to determine the factors that affect the physician labor supply in Iran. We focused on the presence and absence of medical graduate students in the labor market and we also investigated the changes in labor supply in age groups and the differences in male and female physician labor supply. Moreover, the unemployment rate among physicians was calculated. Patients and Methods:In this study, we used population and census data of Iran in 2011. Data of the graduate medical university students were extracted. Some descriptive statistics like the physician labor participation rate and physician unemployment rate were calculated in this study. Also, a regression model for physician labor supply was estimated. Results:The results of this study showed that the physician labor participation rate and the unemployment rate were 61.6% and 7.8%, respectively. Both of these statistics were better than the overall labor force statistics of the country. The unemployment rate of male physicians was lower than female ones and the labor force participation rate for male physicians was higher than female ones. The results of the labor supply regression showed a positive relationship between age, being male, being married and labor supply. Moreover, a negative relationship was found between continuing the study at universities and physician labor supply. Conclusions: In this study, some additional facts about Iranian physician labor behavior were presented. These results alert policymakers about the decisions in human resource management and play a major role in policy decisions.

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Section: Discussionsupporting

confidence: 73%

Physician Labor Participation and Unemployment Rate in Iran

2015

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“…Conversely, positive willingness to pay is the amount of income that a health worker would forego in order to take up a job with desirable characteristics. For example, Vujicic et al [50] estimated the marginal willingness to pay by doctors in Vietnam for various desirable job characteristics, such as urban location and adequate equipment.…”

Section: Resultsmentioning

confidence: 99%

The use of discrete choice experiments to inform health workforce policy: a systematic review

Mandeville

Lagarde

Hanson

2014

BMC Health Serv Res

127

124

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BackgroundDiscrete choice experiments have become a popular study design to study the labour market preferences of health workers. Discrete choice experiments in health, however, have been criticised for lagging behind best practice and there are specific methodological considerations for those focused on job choices. We performed a systematic review of the application of discrete choice experiments to inform health workforce policy.MethodsWe searched for discrete choice experiments that examined the labour market preferences of health workers, including doctors, nurses, allied health professionals, mid-level and community health workers. We searched Medline, Embase, Global Health, other databases and grey literature repositories with no limits on date or language and contacted 44 experts. Features of choice task and experimental design, conduct and analysis of included studies were assessed against best practice. An assessment of validity was undertaken for all studies, with a comparison of results from those with low risk of bias and a similar objective and context.ResultsTwenty-seven studies were included, with over half set in low- and middle-income countries. There were more studies published in the last four years than the previous ten years. Doctors or medical students were the most studied cadre. Studies frequently pooled results from heterogeneous subgroups or extrapolated these results to the general population. Only one third of studies included an opt-out option, despite all health workers having the option to exit the labour market. Just five studies combined results with cost data to assess the cost effectiveness of various policy options. Comparison of results from similar studies broadly showed the importance of bonus payments and postgraduate training opportunities and the unpopularity of time commitments for the uptake of rural posts.ConclusionsThis is the first systematic review of discrete choice experiments in human resources for health. We identified specific issues relating to this application of which practitioners should be aware to ensure robust results. In particular, there is a need for more defined target populations and increased synthesis with cost data. Research on a wider range of health workers and the generalisability of results would be welcome to better inform policy.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6963-14-367) contains supplementary material, which is available to authorized users.

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“…Key cited factors affecting quality are (1) giving better service at private facilities rather at public facilities for the same disease condition and (2) working long hours at night privately, resulting in exhaustion and poor performance in the public sector. Though international evidence indicates that in some instances dual practice may not have an impact on working hours or quality, 23 there is an indication that in Palestine, private hours worked are additional to public hours, which end at three o'clock in the afternoon, and that the effect of dual practice on quality may be more pronounced because the public sector is overburdened compared to a setting where there is considerable lax. For example, a physician in public facilities in Gaza can see up to 50-70 patients daily, which means that a physician can have roughly 18,000 consultations yearly, a number that is much higher than the Organisation for Economic Co-operation and Development (OECD) average of 2,357 consultations per doctor per year.…”

Section: Implications For Access Service Provision and Quality Of Carementioning

confidence: 99%