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Open Access Research article

The impact of economic factors on migration considerations among Icelandic specialist doctors: a cross-sectional study

Ingunn Bjarnadóttir Solberg1*, Kristinn Tómasson2, Olaf Aasland34 and Reidar Tyssen1

Author Affiliations

1 Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.O.B. 1111 Blindern, 0317 Oslo, Norway

2 Department of Research and Occupational Health, Administration for Occupational Health and Safety, 110 Reykjavík, Iceland

3 Institute for Studies of the Medical Profession, The Norwegian Medical Association, P.O.B. 1152 Sentrum, N-0107 Oslo, Norway

4 Department of Health Management and Health Economics, Institute of Health and Society, P.O.B. 1089, 0318 Oslo, Norway

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BMC Health Services Research 2013, 13:524  doi:10.1186/1472-6963-13-524

Published: 18 December 2013

Abstract

Background

Globalization has facilitated the employability of doctors almost anywhere in the world. In recent years, the migration of doctors seems to have increased. However, we lack studies on doctors’ migration from developed countries. Because the economic recession experienced by many countries might have affected the migration of doctors, research on this topic is important for the retention of doctors. Iceland was hit hard by the economic recession in 2008. Therefore, we want to explore how many specialist doctors in Iceland have considered migrating and whether economic factors at work and in private life, such as extensive cost-containment initiatives at work and worries about personal finances, are related to doctors’ migration considerations.

Methods

In 2010, all doctors in Iceland registered with the Icelandic Medical Association were sent an electronic cross-sectional survey by email. The 467 specialists who participated in this study represent 55% of all specialist doctors working in Iceland. Information on doctors’ contemplation of migration was available from responses to the question: “Have you considered moving and working abroad?” The predictor variables in our logistic regression model are perceived cost-containment initiatives at work, stress related to personal finances, experience of working abroad during vacations, job dissatisfaction, job position, age, and gender.

Results

Sixty-three per cent of Iceland’s specialist doctors had considered relocation abroad, 4% were moving in the next year or two, and 33% had not considered relocating. Logistic regression analysis shows that, controlling for age, gender, job position, job satisfaction, and experience of working abroad during vacations, doctors’ migration considerations were significantly affected by their experiences of cost-containment initiatives at work (odds ratio (OR) = 2.0, p < 0.01) and being stressed about personal finances (OR = 1.6, p < 0.001). Age, job satisfaction, and working abroad during vacations also had an effect, whereas job position did not.

Conclusions

Economic factors affect whether specialist doctors in Iceland consider migration. More studies on the effect of economic recession on migration by doctors are needed.

Keywords:
Doctors’ migration; Health-care services; Economic recession; Cost-containment initiatives; Doctors’ job satisfaction; Iceland