DETUROPE - The Central European Journal of Regional Development and Tourism 2022, 14(1):164-188 | DOI: 10.32725/det.2022.009

The migration of health care professionals from Hungary – global flows and local responses

Lajos Borosa, Gábor Dudásb,, Zsófia Ilcsikné Makrac,, Cezar Morard,, Viktor Pále
a Department of Economic and Human Geography, University of Szeged, Egyetem u. 2 6722 Szeged, Hungary
b Institute for Regional Studies, Centre for Economic and Regional Studies, Eötvös Loránd Research Network, H-5600 Békéscsaba, Szabó Dezső u. 42. Hungary
c Department of Economic and Human Geography, University of Szeged, Egyetem u. 2 6722 Szeged, Hungary
d Department of Geography, Tourism and Territorial Planning, University of Oradea, 1 Universităţii Street, 410087 Oradea, Romania
e Department of Economic and Human Geography, University of Szeged, Egyetem u. 2 6722 Szeged, Hungary

The migration of health care workers is a longstanding process which causes shortages in the sending countries. The Eastern enlargements of the European Union strengthened the East-West migration flows causing serious political controversies and jeopardising medical services. Hungary is also heavily affected by these processes and in the last 10 years; thousands of doctors and nurses left the country. Managing migration processes requires complex policy answers with the involvement of actors from various spatial scales – but most of the studies on medical migration from Hungary focuses on the national scale. To fill this research gap, this study aims to analyse local political responses to the outmigration through the content analysis health care development documents to reveal the role of local scale. On local scale individual needs and preferences, emotional factors can influence the decision on staying or moving. Therefore, local policies, which take local features into account and apply place-based approach, can be useful elements of (re)migration policies in the case of health care workers, too.

Keywords: migration, health care, brain drain, Hungary, policy analysis

Published: July 1, 2022  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Boros, L., Dudás, G., Ilcsikné Makra, Z., Morar, C., & Pál, V. (2022). The migration of health care professionals from Hungary – global flows and local responses. DETUROPE - The Central European Journal of Regional Development and Tourism, 14(1), 164-188. doi: 10.32725/det.2022.009
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Akay, A., Bargain, O., & Zimmermann, K. (2013). Home sweet home? Macroeconomic conditions in the home countries and the well-being of migrants. IZA Discussion Papers No. 7862. Bonn, 39. Go to original source...
    2. Albreht, T. (2011). Addressing shortages: Slovenia's reliance on foreign health professionals, current developments and policy responses. Wismar, M. Maier, C.B., Glinos, I.A., Dussault, G. & Figueras, J. (eds.) Health Professional Mobility and Health Systems. Evidence from 17 European countries. European Obervatory on Health Systems and Policies, Brussels, 511-538.
    3. Aluwihare, A.P.R. (2005). Physician migration: donor country impact. The Journal of Continuing Education in the Health Professions, 25, 15-21. Go to original source...
    4. Anthamatten, P., & Hazen, H. (2011). An introduction to the geography of health. Routledge, London and New York, 304.
    5. Apostu, S.A., Vasile, V., Marin, E., & Bunduchi, E. (2022). Factors influencing physicians migration. - A case study from Romania. Mathematics, 10(505), 1-24. Go to original source...
    6. Astor, A., Akhtar, T., Matallana, M.A., Muthuswamy, V., Olowu, F.A., Tallo, V., & Lie, R.K. (2004). Physician migration: Views from professionals in Colombia, Nigeria, India, Pakistan and the Philippines. Social Science & Medicine, 61, 2492-2500. Go to original source...
    7. Bach, S. (2004). Migration patterns of physicians and nurses: still the same story? Bulletin of the World Health Organization, 82(8), 624-625.
    8. Balázs, P. (2009). Új háttérszámítások az orvosi humánerőforrás tervezéséhez. IME, 8(10), 31-36.
    9. Balázs, P. (2012). Orvosi létszámok és a nemzetközi orvosmigráció aktuális hatása Magyarországon. Orvosi Hetilap, 153(7), 250-256. Go to original source...
    10. Beke, S. (2019). Early treatment of acute myocardial infarction and its regional differences in Békés County. Deturope, 11(1), 182-195. Go to original source...
    11. Beine, M., Docquer, F., & Rapoport, H. (2001). Brain drain and economic growth: Theory and Evidence. Journal of Development Economics, 64, 275-289. Go to original source...
    12. Benusová, K. Kovácová, M. Nagy M. & Wismar, M. (2011). Regaining self-sufficiency: Slovakia and the challenges of health professionals leaving the country. Wismar, M. Maier, C.B., Glinos, I.A., Dussault, G. & Figueras, J. (eds.) Health Professional Mobility and Health Systems. Evidence from 17 European countries. European Obervatory on Health Systems and Policies, Brussels, 479-510.
    13. Bhagwati, J., & Hamada, K. (1974). The brain drain, international integration of markets for professionals and unemployment: A theoretical analysis. Journal of Development Economics, 1(1), 19-42. Go to original source...
    14. Bhagwati, J., & Rodriguez, C. (1975). Welfare-theoretical analyses of the brain drain. Journal of Development Economics, 2, 195-221. Go to original source...
    15. Blacklock, C., Heneghan, C., Mant, D., & Ward, A.M. (2012). Effect of UK policy on medical migration: a time series analysis of physician registration data. Human Resources for Health, 10(35), 9. Go to original source...
    16. Blythe, J., Baumann, A., Rhéaume, A., & McIntosh, K. (2009). Nurse migration to Canada pathways and pitfalls of workforce integration. Journal of Transcultural Nursing, 20(2), 202-210. Go to original source...
    17. Boboc, C., Vasile, V., & Ghita, S. (2011). Migration of physicians: Causes and effects in CEE countries. M. Zhou (Ed.): ISAEBD 2011, Part III, CCIS 210, 514-520. Go to original source...
    18. Botezat, A. & Moraru, A. (2020). Brain drain from Romania: what do we know so far about the Romanian medical diaspora? Eastern Journal of European Studies, 11(1), 309-334.
    19. Buchanan, J., Wismar, M., Glinos, I.A., & Bremner, J. eds. (2014). Health professional mobility in a changing Europe. Observatory Studies Series 32. The European Observatory on Health Systems and Policies - World Health Organization, Copenhagen, 398.
    20. Bundred, P.E., & Levitt, C. (2000). Medical migration: who are the real losers? Lancet, 356, 245-246. Go to original source...
    21. Carr, S.C., Inkson, K., & Thorn, K. (2005). From global careers to a talent flow: Reinterpreting 'brain drain', Journal of World Business, 40, 386-398. Go to original source...
    22. Cassarino, J.P. (2004). Theorising return migration: The conceptual approach to return migrants revisited. International Journal on Multicultural Societies, 6(2), 253-279.
    23. Castles, S., & Miller, M.J. (2009). The age of migration. International population movements in the modern world. Palgrave Macmillan, Basingstoke, 392.
    24. Christens, B.D., & Perkins, D.D. (2008). Transdisciplinary, multilevel action research to enhance ecological and psycho-political validity. Journal of Community Psychology 36(2), 214-231. Go to original source...
    25. Clemens, M.A. (2007). Do visas kill? The effects of African health professional emigration. Working Paper Number 114, Center for Global Development, Washington, DC, 56. Go to original source...
    26. Connell, J. (2020). Doctor Retention or Migration: From Ireland to the World? Comment on "Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle" International Journal of Health Policy Management, 10(10), 654-657. Go to original source...
    27. Cooper, R.A. (2005). Physician migration: A challenge for America, a challenge for the World. The Journal of Continuing Education in the Health Professions, 25(1), 8-14. Go to original source...
    28. Crawford, T.J. (1973). Beliefs about birth control: A consistency theory analysis. Representative research in social psychology, 4(1), 53-65.
    29. Docquier, F., & Rapoport, H. (2009). Quantifying the impact of highly-skilled emigration on developing countries. CEPR, Fondazione Rodolfo Debenedetti, 109.
    30. Domagala, A., & Klich, J. (2018). Planning of Polish physician workforce - Systemic inconsistencies, challenges and possible ways forward. Health Policy, 122, 102-108. Go to original source...
    31. Domagala, A., & Dubas-Jakóbczyk, K. (2019). Migration intentions among physicians working in Polish hospitals -Insights from survey research. Health Policy, 123, 782-789. Go to original source...
    32. Domagala, A., Kautsch, M., Kulbat, A., & Parzonka, K. (2022). Exploration of estimated emigration trends of Polish health professionals. International Journal of Environmental Research and Public Health, 19(940), 1-18. Go to original source...
    33. Dovlo, D. (2003). The brain drain and retention of health professionals in Africa. Regional Training Conference on Improving Tertiary Education in Sub-Saharan Africa; Things that Work!, Accra, 10.
    34. Eke, E., Girasek, E., & Szócska, M. (2009). A migráció a magyar orvosok körében. Statisztikai Szemle, 87(7-8), 795-827.
    35. Fejérdy, P., Gerle, J., & Kóbor, A. (2004). A hazai fogorvosi migráció, és a decentralizált fogorvosképzés. Informatika és Menedzsment az Egészségügyben, 3(8), 24-28.
    36. Forcier, M.B., Simoens, S., & Giuffrida, A. (2004). Impact, regulation and health policy implications of physician migration in OECD countries. Human Resources for Health, 2(12), 11. Go to original source...
    37. Füzesi, Z., Szőke, K., Tistyán, L., & Péntek, E. (2001). Települési egészségtervek. A falu. A vidékfejlesztők és környezetgazdálkodók folyóirata, 16(3), 71-76.
    38. George, J.T., Rozario, K.S., Anthony, J., Jude, E.B., & McKay, G.A. (2007). Non-European Union doctors in the National Health Service: why, when and how do they come to the United Kingdom of Great Britain and Northern Ireland? Human Resources for Health, 5(6), 7. Go to original source...
    39. Girasek, E. (2012). Rezidens orvosok szakterület-választási és vidéki munkavállalási motivációi. PhD értekezés, Budapest, 162.
    40. Girasek, E., Csernus, R., Ragány, K., & Eke, E. (2013). Migráció az egészségügyben. Magyar Tudomány, 173(3), 292-298.
    41. Girasek, E., Molnár, R., Eke, E., & Csernus, R. (2009). Az orvosi pálya választásának motivációi napjainkban: Orvostanhallgatók és rezidensek véleménye alapján. Orvosképzés, 84(4), 329-336.
    42. Glinos, I.A. (2015). Health professional mobility in the European Union: Exploring the equity and efficiency of free movement. Health Policy, 119, 1529-1536. Go to original source...
    43. Gostautaite, B., Buciuniene, I., Milasauskiene, Z., Bareikis, K., Bertasiute, E., & Mikelioniene, G. (2018). Migration intentions of Lithuanian physicians, nurses, residents and medical students. Health Policy, 122, 1126-1136. Go to original source...
    44. Grignon, M., Owusu, Y., & Sweetman, A. (2012). The international migration of health professionals. Institute for the Study of Labor, Bonn, Discussion Paper No. 6517, 42. Go to original source...
    45. Groenhout, R. (2012). The "brain drain" problem: Migrating medical professionals and global health care. International Journal of Feminist Approaches to Bioethics, 5(1), 1-24. Go to original source...
    46. Grubel, H., & A. Scott, A. (1966). The International Flow of Human Capital. American Economic Review, 56(1-2), 268-274.
    47. Gyorffy, Z., Dweik, D., & Girasek, E. (2018). Willingness to migrate-a potential effect of burnout? A survey of Hungarian physicians. Human Resources for Health, 16, Article number 36, 8. Go to original source...
    48. Hagopian, A., Ofosu, A., Fatusi, A., Biritiwum, R., Essel, A., Hart, L.G., & Watts, C. (2005). The flight of physicians from East Africa: Views of African physicians and implications for policy. Social Science and Medicine, 61(8), 1750-60. Go to original source...
    49. Hnatiuc, M. (2011). Factor identification of Romanian physician migration. Comparative analysis. Analele Universitatii Maritime Constanta, 12(16), 209-212.
    50. Hoffman, I. (2018). Hungarian Counties and Regional development - Changing Roles in a Transforming Environment. Deturope, 10(3), 162-179. Go to original source...
    51. Humphries, N., McDermott, A.M., Conway, E., Byrne, J-P., Prihodova, L., Costello, R., & Matthews, A. (2019). 'Everything was just getting worse and worse': deteriorating job quality as a driver of doctor emigration from Ireland. Human Resources for Health, 17, Article Number: 97, 11. Go to original source...
    52. Hussey, P.S. (2007). International migration patterns of physicians to the United States: A cross-national panel analysis. Health Policy, 84(2-3), 298-307. Go to original source...
    53. Johnson, H.G. (1979). Some Economic Aspects of the Brain Drain. The Pakistan Development Review, 7(3), 379-441. Go to original source...
    54. Kautsch, M., & Czabanowska, K. (2011). When the grass gets greener at home: Poland's changing incentives for health professional mobility. Wismar, M. Maier, C.B., Glinos, I.A., Dussault, G. & Figueras, J. (eds.) Health Professional Mobility and Health Systems. Evidence from 17 European countries. European Obervatory on Health Systems and Policies, Brussels, 419-448.
    55. Kovács, E., Girasek, E., Kozák, A., Sziklai, M., Bélteki, Z., György, A., Páva, H., & Szócska, M. (2019). Helyzetkép az elvándorlásban érintett orvosi szakterületek hazai humánerőforrás-ellátottságáról. Orvosi Hetilap, 160(31), 1223-1230. Go to original source...
    56. Kroezen, M., Dussault, G., Craveiro, I., Dieleman, M., Jansen, C., Buchan, J., Barriball, L. Rafferty, A.M., Bremner, J. & Sermeus, W. (2015). Recruitment and retention of health professionals across Europe: A literature review and multiple case study research. Health Policy, 119, 1517-1528. Go to original source...
    57. Kuhlmann, E., Groenewegen, P.P., Bond, C., Burau, V., & Hunter, D. J. (2018). Primary care workforce development in Europe: An overview of health system responses and stakeholder views. Health Policy, 122, 1055-1062. Go to original source...
    58. Lados, G., Kovács, Z., Hegedűs, G., & Boros, L. (2013). Challenges of brain drain and obstacles of return migration in Hungary; an empirical perspective. Berichte: Geographies und Landeskunde, 87(4), 441-458.
    59. Lefebvre, H. (1991). The Production of Space. Basil Blackwell, Oxford, 464.
    60. Loewen, B. (2018). From decentralization to re-centralization: Tendencies of regional policy and inequalities in Central and Eastern Europe. Halduskultuur, 18(2), 103-126. Go to original source...
    61. Luboga, S. Hagopian, A., Ndiku, J., Bancroft, E. & McQuide, P. (2011). Satisfaction, motivation, and intent to stay among Ugandan physicians: a survey from 18 national hospitals. International Journal of Health Planning and Management, 26(1), 2-17. Go to original source...
    62. Massey, D.S., Arango, J., Hugo, Gr., Kouaouci, A., Pellegrino, A., & Taylor, J.E. (1993). Theories of International Migration: A Review and Appraisal. Population and Development Review, 19(3), 431-466. Go to original source...
    63. Matutyte, L., Belena, I., Bezborodovs, N., Madissoon, D., & Pinto da Costa, M. (2021). Attitudes towards migration from the eastern coast of the Baltic Sea: similar history but different psychiatric trainees? International Review of Psychiatry, 33(1-2), 16-22. Go to original source...
    64. Meyer, J-PB., & Wattiaux, J-P. (2006). Diaspora Knowledge Networks: Vainishing doubts and increasing evindece. International Journal on Multicultural Societies, 8(1), 4-24.
    65. Morar, C., Tiba, A., Jovanovic, T., Valjarevic, A., Ripp, M., Vujicic, M., Stankov, U., Basarin, B., Ratkovic, R., Popovic, M., Nagy, G. & Boros, L. (2022). Supporting Tourism by Assessing the Predictors of COVID-19 Vaccination for Travel Reasons. International Journal of Environmental Research and Public Health, 19(2), Article number 918 Go to original source...
    66. Nagy, G. (2010). A világgazdaság és a globális munkaerőpiac. In: Mészáros R. és munkaközössége: A globális gazdaság földrajzi dimenziói. Akadémiai Kiadó, Budapest, 229-249.
    67. Nagy, G. (2021). Environmental justice and its geographical aspects in Hungary. Tér és Társadalom, 35(4), 76-103. Go to original source...
    68. OECD (2014). International Migration Overlook 2014. (http://www.oecd-ilibrary.org/social-issues-migration-health/international-migration-outlook_1999124x)
    69. Ognyanova, D., Maier, C.B., Wismar, M., Girasek, E., & Busse, R. (2012). Mobility of health professionals pre and post 2004 and 2007 EU enlargements: Evidence from the EU project PROMeTHEUS. Health Policy, 108(1-2), 122-132. Go to original source...
    70. Okeke, E.N. (2013). Brain drain: Do economic conditions "push" doctors out of developing countries? Social Science & Medicine, 98, 169-178. Go to original source...
    71. Pál, V., & Uzzoli, A. (2008). Az emberiség egészsége - a 21. század kihívása. Földrajzi Közlemények, 132(4), 471-489.
    72. Pál V., Lados, G., Ilcsikné Makra, Z., Boros, L., Uzzoli, A., & Fabula, Sz. (2021). Concentration and inequality in the geographic distribution of physicians in the European Union, 2006-2018. Regional Statistics, 11(3), 3-28. Go to original source...
    73. Patay, T. (2018). Immigration and Regional Competitiveness - Relevant Theories in the Migration Research and in the Regional Science. Deturope, 10(1), 71-81. Go to original source...
    74. Prilleltensky, I. (2008). The role of power in wellness, oppression, and liberation: The promise of psychopolitical validity. Journal of Community Psychology, 36(2), 116-136. Go to original source...
    75. Reid, S.J. (2001). Compulsory Community Service for Doctors in South Africa: Evaluation of the First Year. South African Medical Journal, 91(4), 329-336.
    76. Robinson, R. (2007). The cost and benefits of health worker migration from East and Southern Africa (ESA): a literature review. Discussion paper 49, Equinet, Harare, 56.
    77. Round, J. (2008). Demographic transformations. In: Daniels, P., Bradshaw, M., Shaw, D., Sidaway, S. (eds.): An introduction to human geography. Issues for the 21st century. Pearson Education Limited, Harlow, 83-104.
    78. Rutten, M. (2009). The economic impact of medical migration: a receiving country's perspective'. Review of International Economics, 17(1), 156-171. Go to original source...
    79. Saar, P., & Habicht J. (2011). Migration and attrition: Estonia's health sector and cross-border mobility to its northern neighbour. Wismar, M. Maier, C.B., Glinos, I.A., Dussault, G. & Figueras, J. (eds.) Health Professional Mobility and Health Systems. Evidence from 17 European countries. European Obervatory on Health Systems and Policies, Brussels, 339-364.
    80. Sági, M. (2022). The geographical scales of fear: spatiality of emotions, emotional spatialities. Hungarian Geographical Bulletin, 71(1), 55-65. Go to original source...
    81. Siankam, B. (2012). Physician Brain Drain from Sub-Saharan Africa: Exploring the Utility of an Eco-psychopolitical Validity Framework for Medical Migration Research. Psychosocial Intervention, 20(3), 295-307. Go to original source...
    82. Sociu, S.M., Popescu, C.A., Ciumageanu, M.D. & Buzoianu, A.D. (2017). Human Resources for Health, 15(6), 1-9. Go to original source...
    83. Soja, E.W. (1980). The Socio-Spatial Dialectic. Annals of the Association of American Geographers, 70(2), 207-225. Go to original source...
    84. Solberg, I.B., Tómasson, K., Aasland, O., & Tyssen, R. (2013). The impact of economic factors on migration considerations among Icelandic specialist doctors: a cross-sectional study. BMC Health Services Research, 13, Article number: 524, 7. Go to original source...
    85. Somlódyné Pfeil, I. (2017). Chances of effective urban policy in Hungary under the influence of the European cohesion policy. Deturope, 9(3), 141-161. Go to original source...
    86. Starkiene, L., Macijasukiene, J., Riklikiene, O., Stricka, M., & Padaiga, Z. (2013). Retaining physicians in Lithuania: Integrating research and health policy. Health Policy, 110, 39-48. Go to original source...
    87. Sussman, N.M. (2010). Return migration and identity: A global phenomenon, a Hong Kong case. Hong Kong University Press, Hong Kong, 364.
    88. Szabó, P., Józsa, V., Gordos, T. (2021). Cohesion policy challenges and discovery in 2021-2027. The case of Hungary. Deturope, 13(2), 66-100. Go to original source...
    89. Szatmári, A., & Hoffman, I. (2020). The transformation of the municipal social care system in Hungary - in the light of the provision of home care services. Lex Localis, 18(4), 691-712. Go to original source...
    90. Tankwanchi, A.B.S. (2012). Doctors beyond borders: data trends and medical migration dynamics from Sub-Saharan Africa to the United States. PhD dissertation, Vanderbuilt University, Nashville, 186. Go to original source...
    91. Uzzoli, A., Egri, Z., Szilágyi, D., & Pál, V. (2020). Does better availability mean better accessibility? Spatial inequalities in the care of acute myocardial infarction in Hungary. Hungarian Geographical Bulletin, 69(4), 401-418. Go to original source...
    92. Watkins, S. (2005). Migration of health care professionals: practical and ethical consideration. Clinical Medicine, 5, 240-263. Go to original source...
    93. Witter, S., Hamza, M.M., Alazemi, N., Alluhidan, M., Alghaith, T., & Herbst, C.H. (2020). Human resources for health interventions in high- and middle-income countries: findings of an evidence review. Human Resources for Health, 18(43), 17. Go to original source...
    94. Wolpert, J. (1965). Behavioral aspects of the decision to migrate. Papers in Regional Science, 15(1), 159-169. Go to original source...
    95. Zelinsky, W. (1971). The hypothesis of the mobility transition. Geographical Review, 61(2), 219-249. Go to original source...
    96. Zuk, P., Zuk, P., & Lisiewicz-Jakubaszko, J. (2019). Labour migration of doctors and nurses and the impact on the quality of health care in Eastern European countries: The case of Poland. The Economic and Labour Relations Review, 30(2), 307-320. Go to original source...
    97. Semmelweis Plan (2011). Újraélesztett egészségügy. Gyógyuló Magyarország Semmelweis Terv az egészségügy megmentésére. Nemzeti Erőforrás Minisztérium Egészségügyért Felelős Államtitkárság, Budapest.
    98. Béla Johan Programme (2002). Egészség évtizedének Johan Béla nemzeti programja. Egészségügyi, Szociális és Családügyi Minisztérium, Budapest.

    This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content