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

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  • Vujicic, Marko
  • Shengelia, Bakhuti
  • Alfano, Marco
  • Thu, Ha Bui
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    Abstract

    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.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 73 (2011)
    Issue (Month): 7 ()
    Pages: 970-977

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    Handle: RePEc:eee:socmed:v:73:y:2011:i:7:p:970-977

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    Related research

    Keywords: Human resources for health; Vietnam; Labor market; Discrete choice experiment; Retention; Physician shortage;

    References

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    1. Regier, Dean A. & Ryan, Mandy & Phimister, Euan & Marra, Carlo A., 2009. "Bayesian and classical estimation of mixed logit: An application to genetic testing," Journal of Health Economics, Elsevier, vol. 28(3), pages 598-610, May.
    2. Kolstad, Julie Riise, 2008. "How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania," Working Papers in Economics 15/08, University of Bergen, Department of Economics.
    3. Christophe Lemiere & Christopher H. Herbst & Negda Jahanshahi & Ellen Smith & Agnes Soucat, 2011. "Reducing Geographical Imbalances of Health Workers in Sub-Saharan Africa : A Labor Market Perspective on What Works, What Does Not, and Why," World Bank Publications, The World Bank, number 5919, October.
    4. Louviere, Jordan J. & Lancsar, Emily, 2009. "Choice experiments in health: the good, the bad, the ugly and toward a brighter future," Health Economics, Policy and Law, Cambridge University Press, vol. 4(04), pages 527-546, October.
    5. Pieter Serneels & Jose G. Montalvo & Gunilla Pettersson & Tomas Lievens & Jean Damascene Butera & Aklilu Kidanu, 2010. "Who Wants to Work in a Rural Health Post? The Role of Intrinsic Motivation, Rural Background and Faith-Based Institutions in Rwanda and Ethiopia," CSAE Working Paper Series 2010-10, Centre for the Study of African Economies, University of Oxford.
    6. World Bank, 2010. "Africa Development Indicators 2010 : Silent and Lethal, How Quiet Corruption Undermines Africa's Development," World Bank Publications, The World Bank, number 2431, October.
    7. Jacob Mincer, 1958. "Investment in Human Capital and Personal Income Distribution," Journal of Political Economy, University of Chicago Press, vol. 66, pages 281.
    8. Scott, Anthony, 2001. "Eliciting GPs' preferences for pecuniary and non-pecuniary job characteristics," Journal of Health Economics, Elsevier, vol. 20(3), pages 329-347, May.
    9. Milton Friedman, 1957. "A Theory of the Consumption Function," NBER Books, National Bureau of Economic Research, Inc, number frie57-1, May.
    10. Chomitz, Kenneth M. & Setiadi, Gunawan & Azwar, Azrul & Ismail, Nusye & Widiyarti, 1998. "What do doctors want? developing incentives for doctors to serve in Indonesia's rural and remote areas," Policy Research Working Paper Series 1888, The World Bank.
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    Cited by:
    1. Windle, Jill & Rolfe, John, 2013. "Using discrete choice experiments to assess the preferences of new mining workforce to commute or relocate to the Surat Basin in Australia," Resources Policy, Elsevier, vol. 38(2), pages 169-180.

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