Skip to main content
SpringerLink
Log in
Book cover

Health Care Provision and Patient Mobility pp 67–80Cite as

The Possible Effects of Health Professional Mobility on Access to Care for Patients

  • Chapter
  • First Online:

  • 1587 Accesses

Part of the book series: Developments in Health Economics and Public Policy ((HEPP,volume 12))

Abstract

The chapter explains how health professional mobility impacts on the resources and capacity available within a health system, and how this affects service delivery and access. The contrasting experiences of destination countries, which receive foreign inflows of health professionals, and of source countries, which loose workforce due to outflows, are illustrated with country examples. The evidence opens the debate on how EU countries compete for health workforce, what this means for resource-strained, crisis-hit Member States, and whether there is any room for intra-European solidarity. The nexus between patient mobility and health professional mobility is moreover highlighted. This take on free mobility in the EU has received little attention, and while evidence is scarce, it calls for careful analysis when considering the possible effects of free movement on access to care in national health systems. The chapter reformulates the question on ‘who wins’ and ‘who looses’ from freedom of movement in the EU to turn our attention away from those who go abroad for care and instead focus on those who stay at home.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Notes

  1. 1.

    A distinction is made here between planned care for which the patients travels deliberately to another country, and emergency care which the patient needs while traveling abroad. In this chapter, ‘patient mobility’ refers only to traveling abroad for planned care.

  2. 2.

    http://ec.europa.eu/health-eu/europe_for_patients/about/index_en.htm.

  3. 3.

    Dutch Health Insurance Board. www.cvz.nl/zorgcijfers/zvw-lasten/zvw-lasten.html.

  4. 4.

    Austria, Belgium, Estonia, Finland, France, Germany, Hungary, Italy, Lithuania, Poland, Romania, Serbia, Slovakia, Slovenia, Spain, Turkey, and the UK.

  5. 5.

    Australia, Canada, Ireland, New Zealand, Norway, Sweden, Switzerland, and the USA.

  6. 6.

    Interviews with representative from nursing staff association (28 March 2012) and HR advisor (3 April 2012), Maastricht University Hospital.

  7. 7.

    Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems, OJ 23.04. 2004, L166/1 (formerly Regulation EEC No 1408/71).

  8. 8.

    Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border health care. Official Journal of the European Union 2011; 54; 45–65. http://eurlex.europa.eu/JOHtml.do?uri=OJ:L:2011:088:SOM:EN:HTML

References

  • Association of American Medical Colleges. (2010). The impact of health care reform on the future supply and demand for physicians updated projections through 2025. Washington: AAMC Centre for Workforce Studies.

    Google Scholar 

  • Ballard, K. D., Robinson, S. I., & Laurence, P. B. (2004). Why do general practitioners from France choose to work in London practices? A qualitative study. British Journal of General Practice, 54(Oct), 747–752.

    Google Scholar 

  • Beňušová, K., et al. (2011). Regaining self-sufficiency: Slovakia and the challenges of health professionals leaving the country. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Bertinato, L., Glinos, I. A., Boscolo, E., & Ciato, L. (2011). Oversupplying doctors but seeking carers: Italy’s demographic challenges and health professional mobility. In M. Wismar et al. (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series No. 23. European Observatory on Health Systems and Policies/ World Health Organization.

    Google Scholar 

  • Blitz, B. K. (2005). 'Brain circulation': The Spanish medical profession and international recruitment in the United Kingdom. Journal of European Social Policy, 15(4), 363–379.

    Google Scholar 

  • Buchan, J., May, F., & Dussault, G. (2014). Nursing workforce policy and the economic crisis: A global overview. Journal of Nursing Scholarship, 45(3), 298–307. doi:10.1111/jnu.12028, http://onlinelibrary.wiley.com/doi/10.1111/jnu.12028/abstract.

    Google Scholar 

  • Cullen, P. (2012). Nearly €2m spent on recruiting doctors in India and Pakistan. The Irish Times, 16 Feb.

    Google Scholar 

  • Delamaire, M. L., & Schweyer, F. X. (2011). Nationally moderate, locally significant: France and health professional mobility from far and near. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Dussault, G., & Buchan, J. (2014 forthcoming). The economic crisis in the EU: impact on health workforce mobility. In J. Buchan, M. Wismar, I. A. Glinos, & J. Bremner (Eds.), Health professional mobility in a changing Europe: New dynamics, mobile individuals and policy responses (working title). Observatory Studies Series. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • EC. (2012). Commission staff working document on an action plan for the EU health workforce SWD (2012) 93 final, Strasbourg. Retrieved April 18, 2012 from http://ec.europa.eu/dgs/health_consumer/docs/swd_ap_eu_healthcare_workforce_en.pdf.

  • Eke, E., Girasek, E., & Szocska, M. (2011). From melting pot to laboratory of change in central Europe: Hungary and health workforce migration. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Galan, A., Olsavszky, V., & Vladescu, C. (2011). Emergent challenges of health professional emigration: Romania’s accession to the EU. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Glinos, I. A., Baeten, R., Helble, M., & Maarse, H. (2010). A typology of cross-border patient mobility. Health and Place, 16(6), 1145–1155. 2010 Nov. doi: 10.1016/j.healthplace.2010.08.001.

    Google Scholar 

  • Glinos, I. A., Wismar, M., Maier, C. B., Palm, W., & Figueras, J. (2011). Health professional mobility and health systems in Europe: conclusions from the case-studies. In M. Wismar et al. (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series No. 23. Copenhagen: European Observatory on Health Systems and Policies/ World Health Organization.

    Google Scholar 

  • Glinos, I. A. (2012). Worrying about the wrong thing: patient mobility versus health professional mobility. Journal of Health Services Research and Policy, 17(4), 254–256. doi:10.1258/jhsrp.2012.012018.

    Google Scholar 

  • Glinos, I. A., Doering, N., & Maarse, H. (2012). traveling home for treatment and EU patients' rights to care abroad: results of a survey among German students at Maastricht University. Health Policy 2012, 105(1), 38–45. doi:10.1016/j.healthpol.2011.12.008.

    Google Scholar 

  • Humphries, N., Tyrrell, E., McAleese, S., Bidwell, P., Thomas, S., Normand, C., & Brugha, R. (2013 forthcoming). Brain gain, waste and drain-a qualitative study of non-EU migrant doctors in Ireland. Human Resources for Health.

    Google Scholar 

  • Irish Medical Organisation. (2006). IMO Position Paper on Medical Schools. 2006, Irish Medical Organisation, Dublin.

    Google Scholar 

  • Jekic, I. et al. (2011). Geopolitics, economic downturn and oversupply of medical doctors: serbia’s emigrating health professionals. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Kaitelidou, D., & Kouli, E. (2012). Greece: The health system in a time of crisis. Eurohealth (incorporating Eurohealth Observer), 18(1), 12–14.

    Google Scholar 

  • Kautsch, M., & Czabanowska, K. (2011). When the grass gets greener at home: Poland’s changing incentives for health professional mobility. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • López-Valcárcel, B. G., Barber Perez, P., & Quintana, C. D. D. (2011). Opportunities in an expanding health service: Spain between Latin America and Europe. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Lupieri, S. (2013). Where have Europe’s nurses gone? CNN Retrieved May 21 2013, from http://edition.cnn.com/2013/05/21/health/europe-nursing-shortage/index.html?hpt=hp_c3.

  • Maier, C. B., Glinos, I. A., Wismar, M., Bremner, J., Dussault, G., & Figueras, J. (2011). Cross-country analysis of health professional mobility in Europe: the results. In Wismar et al. (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series No. 23. Copenhagen: European Observatory on Health Systems and Policies/ World Health Organization.

    Google Scholar 

  • Mladovsky, P., Srivastava, D., Cylus, J., Karanikolos, M., Evetovits, T., Thomson, S., & McKee, M. (2012). Health policy responses to the financial crisis in Europe. Policy summary 5. Copenhagen: World Health Organization on behalf of the European Observatory on Health Systems and Policies.

    Google Scholar 

  • Offermanns, G., Malle, E.M., & Jusic, M. (2011). Mobility, language and neighbours: Austria as source and destination country. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • OECD. (2012). Health at a glance: Europe 2012. Paris: OECD Publishing. Retrieved from doi:10.1787/9789264183896-en.

    Google Scholar 

  • Ognyanova, D., & Busse, R. (2011). A destination and a source: Germany manages regional health workforce dispraties with foreign medical doctors. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Padaiga, Z., Pukas, M., & Starkiene, L. (2011). Awareness, planning and retention: Lithuania's approach to managing health professional mobility. In M. Wismar et al (Eds.) Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series No. 23. European Observatory on Health Systems and Policies/ World Health Organization.

    Google Scholar 

  • Palm, W., & Glinos, I. A. (2010). Enabling patient mobility in the EU: Between free movement and coordination. In E. Mossialos, G. Permanand, R. Baeten, & T. Hervey (Eds.), Health systems governance in Europe: The role of EU law and policy (pp. 509–560). Cambridge: Cambridge University Press.

    Google Scholar 

  • Saar, P., & Habicht, J. (2011). Migration and attrition: Estonia’s health sector and cross-border mobility to its northern neighbour. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Thomas, S., & Burke, S. (2012). Coping with austerity in the Irish health system. Eurohealth incorporating Eurohealth Observer, 18(1), 7–9.

    Google Scholar 

  • Wilson, J. (2012). Your health care is covered, but who’s going to treat you? CNN Retrieved from June 29, 2012, from http://edition.cnn.com/2012/06/29/health/doctor-shortage-affordable-care-act/index.html.

  • Wismar, M., Maier, C. B., Glinos, I. A., Dussault, G., & Figueras, J. (Eds.). (2011). Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Yun, H., Jie, S., & Anli, J. (2010). Nursing shortage in China: State, causes, and strategy. Nursing Outlook, 58, 122–128.

    Article  Google Scholar 

  • Young, R. (2011). A major destination country: The United Kingdom and its changing recruitment policies. In M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault, & J. Figueras (Eds.), Health professional mobility and health systems: Evidence from 17 European countries. Observatory Studies Series 23. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. European Observatory on Health Systems and Policies, Rue de l’Autonomie 4, 1070, Brussels, Belgium

    Irene A. Glinos

Authors
  1. Irene A. Glinos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Irene A. Glinos .

Editor information

Editors and Affiliations

  1. Department of Economics and Management, University of Brescia, Brescia, Italy

    Rosella Levaggi

  2. Department of Economics, University of Genoa, Genova, Italy

    Marcello Montefiori

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Italia

About this chapter

Cite this chapter

Glinos, I.A. (2014). The Possible Effects of Health Professional Mobility on Access to Care for Patients. In: Levaggi, R., Montefiori, M. (eds) Health Care Provision and Patient Mobility. Developments in Health Economics and Public Policy, vol 12. Springer, Milano. https://doi.org/10.1007/978-88-470-5480-6_4

Download citation

Publish with us

Policies and ethics

Search

Navigation