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Barefoot and footloose doctors: optimal resource allocation in developing countries with medical migration

Author

Listed:
  • John E. Roemer

    (Yale University)

  • Pedro Rosa Dias

    (Imperial College London)

Abstract

In light of the shortage of healthcare professionals, many developing countries operate a de facto two-tiered system of healthcare provision, in which Community Health Workers (CHWs) supplement service provision by fully qualified physicians. CHWs are relatively inexpensive to train but can treat only a limited range of medical conditions. This paper explicitly models a two-tiered structure of healthcare provision and characterizes the optimal allocation of resources between training doctors and CHWs, and implications for population health outcomes. We analyze how medical migration alters resource allocation and population health outcomes, shifting resources towards training CHWs. In the model, migration stimulates health care provision at the lower end of the illness severity spectrum, improving health outcomes for those patients; sufferers of relatively severe medical conditions who can only be treated by doctors are made worse off. It is further shown that donor countries must be reimbursed by at least the training cost of emigrating physicians in order to restore aggregate population health to the pre-migration level.

Suggested Citation

  • John E. Roemer & Pedro Rosa Dias, 2016. "Barefoot and footloose doctors: optimal resource allocation in developing countries with medical migration," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 46(2), pages 335-358, February.
  • Handle: RePEc:spr:sochwe:v:46:y:2016:i:2:d:10.1007_s00355-015-0916-1
    DOI: 10.1007/s00355-015-0916-1
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    1. McCulloch, Rachel & Yellen, Janet L., 1975. "Consequences of a tax on the brain drain for unemployment and income inequality in less developed countries," Journal of Development Economics, Elsevier, vol. 2(3), pages 249-264, September.
    2. Kangasniemi, Mari & Winters, L. Alan & Commander, Simon, 2007. "Is the medical brain drain beneficial? Evidence from overseas doctors in the UK," Social Science & Medicine, Elsevier, vol. 65(5), pages 915-923, September.
    3. Frédéric Docquier & Hillel Rapoport, 2012. "Globalization, Brain Drain, and Development," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 681-730, September.
    4. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    5. Abhijit Banerjee & Angus Deaton & Esther Duflo, 2004. "Wealth, Health, and Health Services in Rural Rajasthan," American Economic Review, American Economic Association, vol. 94(2), pages 326-330, May.
    6. Beine, Michel & Docquier, Frederic & Rapoport, Hillel, 2001. "Brain drain and economic growth: theory and evidence," Journal of Development Economics, Elsevier, vol. 64(1), pages 275-289, February.
    7. Rodriguez, Carlos Alfredo, 1975. "Brain drain and economic growth : A dynamic model," Journal of Development Economics, Elsevier, vol. 2(3), pages 223-247, September.
    8. Angus Deaton, 2011. "What does the empirical evidence tell us about the injustice of health inequalities?," Working Papers 1364, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
    9. McCulloch, Rachel & Yellen, Janet L, 1977. "Factor Mobility, Regional Development, and the Distribution of Income," Journal of Political Economy, University of Chicago Press, vol. 85(1), pages 79-96, February.
    10. Bhargava, Alok & Docquier, Frédéric & Moullan, Yasser, 2011. "Modeling the effects of physician emigration on human development," Economics & Human Biology, Elsevier, vol. 9(2), pages 172-183, March.
    11. repec:dau:papers:123456789/11393 is not listed on IDEAS
    12. Bhagwati, Jagdish & Hamada, Koichi, 1974. "The brain drain, international integration of markets for professionals and unemployment : A theoretical analysis," Journal of Development Economics, Elsevier, vol. 1(1), pages 19-42, April.
    13. repec:pri:cheawb:what_does_the_empirical_evidence_tell_us_about_the_injustice.pdf is not listed on IDEAS
    14. Lisa Chauvet & Flore Gubert & Sandrine Mespl�-Somps, 2013. "Aid, Remittances, Medical Brain Drain and Child Mortality: Evidence Using Inter and Intra-Country Data," Journal of Development Studies, Taylor & Francis Journals, vol. 49(6), pages 801-818, June.
    15. Alok Bhargava & Frédéric Docquier, 2008. "HIV Pandemic, Medical Brain Drain, and Economic Development in Sub-Saharan Africa," The World Bank Economic Review, World Bank Group, vol. 22(2), pages 345-366, May.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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