The World Bank, Human Development Network, 1818 H St NW, Washington, DC 20433, USA.
Soc Sci Med. 2011 Oct;73(7):970-7. doi: 10.1016/j.socscimed.2011.06.010. Epub 2011 Jul 24.
This paper investigates labor market dynamics for physicians in Vietnam, paying particular attention to geographic distribution and dual job holding. The analysis is based on a survey of a random sample of physicians in 3 regions in 2009-10. We found that the labor market for physicians in Vietnam is characterized by very little movement among both facility levels and geographic areas. Dual practice is also prominent, with over one-third of physicians holding a second job. After taking account of the various sources of income for physicians and controlling for key factors, there is a significant wage premium associated with locating in an urban area. This premium is driven by much higher earnings from dual job holding rather than official earnings in the primary job. There are important policy implications that emerge. With such low job turnover rates, policies to increase the number of physicians in rural areas could focus on initial recruitment. Once in place, physicians tend to remain in their jobs for a very long time. Lastly, findings from an innovative discrete choice experiment suggest that providing long-term education and improving equipment are the most effective instruments to recruit physicians to work in rural areas.
本文考察了越南医生的劳动力市场动态，特别关注了地理分布和双重职业。分析基于 2009-10 年对三个地区的随机医生样本进行的调查。我们发现，越南的医生劳动力市场在设施水平和地理区域之间几乎没有任何流动。双重执业也很突出，超过三分之一的医生有第二份工作。在考虑了医生的各种收入来源并控制了关键因素后，在城市地区工作与显著的工资溢价相关。这种溢价是由双重职业带来的更高收入驱动的，而不是主要工作中的官方收入。这其中有一些重要的政策启示。由于这种低的工作周转率，在农村地区增加医生数量的政策可以集中在最初的招聘上。一旦到位，医生往往会在很长一段时间内留在他们的工作岗位上。最后，一项创新的离散选择实验的结果表明，提供长期教育和改善设备是吸引医生到农村地区工作的最有效手段。
