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医生劳动力供应是否存在“猪周期”?培训和移民政策如何应对医生短缺。

Is there a 'pig cycle' in the labour supply of doctors? How training and immigration policies respond to physician shortages.

机构信息

LEM-CNRS, University of Lille and Chaire Transitions Démographiques, Transitions Economiques, France.

Center of Economics and Management of Indian Ocean (CEMOI) from University of Reunion Island, France; International Migration Institute (IMI) from University of Oxford, UK; Institute for Research and Information in Health Economics (IRDES), France.

出版信息

Soc Sci Med. 2018 Mar;200:227-237. doi: 10.1016/j.socscimed.2018.01.038. Epub 2018 Jan 31.

DOI:10.1016/j.socscimed.2018.01.038
PMID:29425902
Abstract

Many OECD countries are faced with the considerable challenge of a physician shortage. This paper investigates the strategies that OECD governments adopt and determines whether these policies effectively address these medical shortages. Due to the amount of time medical training requires, it takes longer for an expansion in medical school capacity to have an effect than the recruitment of foreign-trained physicians. Using data obtained from the OECD (2014) and Bhargava et al. (2011), we constructed a unique country-level panel dataset that includes annual data for 17 OECD countries on physician shortages, the number of medical school graduates and immigration and emigration rates from 1991 to 2004. By calculating panel fixed-effect estimates, we find that after a period of medical shortages, OECD governments produce more medical graduates in the long run but in the short term, they primarily recruit from abroad; however, at the same time, certain practising physicians choose to emigrate. Simulation results show the limits of recruiting only abroad in the long term but also highlight its appropriateness for the short term when there is a recurrent cycle of shortages/surpluses in the labour supply of physicians (pig cycle theory).

摘要

许多经合组织国家都面临着医生短缺的巨大挑战。本文研究了经合组织政府采取的策略,并确定这些政策是否能有效地解决这些医疗短缺问题。由于医学培训需要大量时间,医学院容量的扩大需要更长的时间才能产生效果,而外国培训医生的招聘则更快。我们利用经合组织(2014 年)和巴尔加瓦等人(2011 年)的数据,构建了一个独特的国家级面板数据集,其中包括 1991 年至 2004 年期间 17 个经合组织国家的医生短缺、医学院毕业生人数以及移民和移民率的年度数据。通过计算面板固定效应估计,我们发现,在经历了一段时间的医疗短缺后,经合组织国家从长远来看会培养出更多的医学毕业生,但在短期内,他们主要从国外招聘;然而,与此同时,一些执业医生选择移民。模拟结果表明,长期仅从国外招聘的局限性,但也突出了在医生劳动力供应出现周期性短缺/过剩(猪周期理论)时,短期招聘的合理性。

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