移民的经济激励是什么？对加勒比地区和热门目的地国家工作的卫生工作者之间的工资差距进行分析。

What is the financial incentive to immigrate? An analysis of salary disparities between health workers working in the Caribbean and popular destination countries.

机构信息

Health Economics and HIV and AIDS Division, University of KwaZulu-Natal, Durban, South Africa.

School of Accounting, Economics and Finance, University of KwaZulu-Natal, Durban, South Africa.

出版信息

BMC Health Serv Res. 2019 Feb 8;19(1):109. doi: 10.1186/s12913-019-3896-5.

DOI:10.1186/s12913-019-3896-5

PMID:30736771

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6368691/

Abstract

BACKGROUND

The continuous migration of Human Resources for Health (HRH) compromises the quality of health services in the developing supplying countries. The ability to increase earnings potentially serves as a strong motivator for HRH to migrate abroad. This study adds to limited available literature on HRH salaries within the Caribbean region and establishes the wage gap between selected Caribbean and popular destination countries.

METHODS

Salaries are reported for registered nurses, medical doctors and specialists. Within these cadres, experience is incorporated at three different levels. Earnings are compared using purchasing power parity (PPP) exchange rates allowing for cost of living adjusted salary differentials, awarded to different levels of work experience for the chosen health cadres in the selected Caribbean countries (Jamaica, Dominica, St Lucia and Grenada) and the three destination countries (United States, United Kingdom and Canada).

RESULTS

Registered nurses in the destination countries, across all experience levels, have greater spending power compared to their Caribbean counterparts. Recently qualified registered nurses earn substantially more in the UK (86.4%), US (214.2%) and Canada (182.5% more). The highest PPP salary ($) gap amongst more experienced nurses (5-10 years) is found within the US, with a gap of 163.9%. PPP salary gaps amongst medical doctors were pronounced, with experienced cadres (10-20 years of experience) in the US earning 316.3% more than their Caribbean counterparts, whilst UK doctors (183.5%) and Canadian doctors (251.3%) also earning significantly more. Large salary differentials remained for medical specialists and consultants. US specialist salaries were 540.4% higher than their Caribbean based counterparts, whilst UK and Canadian specialists earned 95.2 and 181.6% more respectively.

CONCLUSION

The PPP adjusted HRH salaries in the three destination countries are superior to those of comparable HRH working in the Caribbean countries selected. The extent of the salary gaps vary according to country and the health cadre under examination, but remain considerable even for newly qualified HRH. The financial incentive to migrate for HRH trained and working in the Caribbean region remains strong, with governments having to consider earning potential abroad when formulating policies and strategies aimed at retaining health professionals.

摘要

背景

卫生人力资源（HRH）的持续流动，影响了发展中供应国的医疗服务质量。增加收入的能力可能是 HRH 移民到国外的强大动力。本研究补充了加勒比地区有限的关于 HRH 薪酬的文献，并确定了选定的加勒比和热门目的地国家之间的工资差距。

方法

报告了注册护士、医生和专家的薪酬。在这些职业中，将经验纳入三个不同级别。使用购买力平价（PPP）汇率进行比较，以考虑到生活成本调整的薪酬差异，这些差异适用于所选加勒比国家（牙买加、多米尼克、圣卢西亚和格林纳达）和三个目的地国家（美国、英国和加拿大）中选定的卫生人员的不同工作经验级别。

结果

在所有经验水平上，目的地国家的注册护士比加勒比地区的同行拥有更大的消费能力。最近合格的注册护士在英国（86.4%）、美国（214.2%）和加拿大（182.5%）的收入要高得多。经验更丰富的护士（5-10 年）的最高 PPP 工资（美元）差距在美国，差距为 163.9%。医生的 PPP 工资差距显著，经验丰富的医生（10-20 年经验）在美国的收入比加勒比地区的同行高 316.3%，而英国医生（183.5%）和加拿大医生（251.3%）的收入也明显更高。医学专家和顾问的薪酬差距仍然很大。美国专家的工资比加勒比地区的同行高出 540.4%，而英国和加拿大的专家则分别高出 95.2%和 181.6%。

结论

在三个目的地国家，经购买力平价调整后的 HRH 薪酬高于所选加勒比国家中从事类似工作的 HRH。工资差距的程度因国家和所检查的卫生人员类别而异，但即使是新合格的 HRH，差距仍然相当大。对于在加勒比地区接受培训和工作的 HRH 来说，移民的经济激励仍然很强，政府在制定旨在留住卫生专业人员的政策和战略时，必须考虑到国外的收入潜力。