HEALTH WORKFORCE MIGRATION:
RESULTS FROM 2013-14 PILOT DATA
COLLECTION AND PROPOSAL TO ADD
MODULE IN THE JOINT QUESTIONNAIRE
OECD Health Data National Correspondents
23 October 2014, Paris
OECD pilot data collection in 2013-14
• Aim: Begin to update data on international migration of
foreign-trained doctors and nurses in OECD countries:
– first reported in 2007 chapter in OECD International Migration Outlook
– data collection pursued in OECD Health Data questionnaire up to 2009
• Part of broader OECD project, also including data collection
on foreign-born doctors and nurses (based on the wave of
national census around 2010/11)
• Begin to analyse impact of a number of recent developments
on migration trends (e.g., economic crisis in 2008-09, EU
enlargement in 2004 and 2007, Global Code on the
International Recruitment of Health Personnel in 2010)
• Work done in collaboration with WHO-Headquarters
Scope and approach to pilot data collection
• Focus on doctors and nurses
• Focus on place of training (foreign-trained, where
first diploma was obtained)
• Collect immigration data from destination countries
by all countries of origin (based on professional
registries, physician/nurse surveys, other sources)
• Include both total “stock” and annual “flows”
• Time series (from 2000 to 2012)
Results of pilot data collection
in terms of data availability
• Doctors:
– Stock: 25 countries (out of 29), including 20 with data
by countries of origin
– Flow: 19 countries (out of 29), including 16 with data
by countries of origin
• Nurses:
– Stock: 23 countries (out of 29), including 16 with data
by countries of origin
– Flow: 16 countries (out of 29), including 13 with data
by countries of origin
Note: This pilot data collection was not carried out in Greece, Iceland, Luxembourg, Mexico and Turkey.
Data sources for pilot data collection
Doctors
Australia
Austria
Belgium
Australian Institute of Health and Welfare (AIHW)
Austrian Medical Chamber
Federal Public Service - Public Health, Database of health work professionals (INAMI - RIZIV)
Canada
Canadian Institute for Health Information, Scott’s Medical Database (SMDB)
Chile
Czech Republic
Denmark
Estonia
Finland
France
Germany
Hungary
Ireland
Israel
Registro Nacional de Prestadores Individuales de Salud
Czech Medical Chamber
Statens Serum Institut, Population Register
Health Board, Register of Health Professionals
National Supervisory Authority for Welfare and Health, Central Register of Health Care Professionals
Ordre des Médecins
German Medical Association
Office of Health Authorisation and Administrative Procedures, Operational Registry
Irish Medical Council, Medical Council Annual Report
Health Information Division, Ministry of Health, Physician License Registry
Netherlands
CIBG, Beroepen in de Gezondheidszorg (BIG)
New Zealand
Norway
Poland
Slovak Republic
Slovenia
Spain
Sweden
Switzerland
United Kingdom
United States
Medical Council of New Zealand, Medical Register
Norwegian Registration Authority for Health Personnel, the health personnel register
Polish Supreme Chamber of Physicians and Dentists, Central Register of Physicians and Dentists
National administrative register of healthcare professionals
National Institute of Public Health Slovenia, National Healthcare Providers Database
Regional Councils of Physicians, National Institute of Statistics
National Board of Health and Welfare, NPS-register
Fédération des médecins suisses (FMH)
ISD Scotland, HSCIC and GMS Census (Wales)
American Medical Association, Physician Master Files
Data sources for pilot data collection
Nurses
Australia
Belgium
Canada
Chile
Denmark
Estonia
Finland
National health Workforce dataset, Health Workforce Australia
Federal Public Service - Public Health, Database of health work professionels, (INAMI - RIZIV)
Canadian Institute for Health Information, Nursing Database
Registro Nacional de Prestadores Individuales de Salud
Statens Serum Institut, Population Register
Health Board, Register of Health Professionals
National Supervisory Authority for Welfare and Health, Central Register of Health Care Professionals
France
DRESS, Répertoire Adeli des professions de santé
Federal Statistical Office in cooperation with the Federal Statistical Offices of the Länder, Statistics for
the Federal Recognition Act (2012)
Ireland
Irish Nursing Board, An Board Altranais
Israel
Health Information Division, Ministry of Health, Nurse License Registry
Italy
Federazione nazionale dei Collegi Ipasvi
Netherlands
CIBG, Beroepen in de Gezondheidszorg (BIG)
New Zealand
Nursing Council of New Zealand, New Zealand Workforce Survey Data
Norway
Norwegian Registration Authority for Health Personnel, the health personnel register
Poland
Main Chamber of Nurses and Midwifes, Central Register of Nurses and Midwifes
Portugal
Ordem dos Enfermeiros, Gestão de Membros da Ordem dos Enfermeiros
Slovenia
National Institute of Public Health Slovenia, National Healthcare Providers Database
Spain
Regional Councils of Nurses, National Institute of Statistics
Sweden
National Board of Health and Welfare, NPS-register
Switzerland
FSO Swiss Federal Statistical Office, Administrative Hospital Statistics
United Kingdom Nursing and Midwifery Council
United States
2013 National Workforce Survey of Registered Nurses, National Council of State Boards of Nursing
Germany
Data comparability limitations and
other issues
• Same type of comparability limitations as for the broader
data collection on the total number of doctors or nurses
(e.g., data for some countries relate to “professionally
active” or “all licensed to practice” rather than “practising”,
many countries exclude physicians-in-training)
• Some countries (e.g., Germany) are only able to report data
based on “foreign nationality” (not foreign-trained)
• Problem in distinguishing “foreign-born and foreigntrained” students from “domestic-born but foreigntrained” students returning to their home country
(“internationalisation of medical and nursing education”)
Proposal to add a new module in the
2015 Joint Questionnaire
• Aim: Collect a relevant minimum dataset:
– to fill current gap in OECD, Eurostat, WHO-Europe databases
– to serve also as an input to national reporting under the WHO
Global Code (requirement once every three years)
• Approach: Follow same specifications as under the OECD
pilot data collection, but with an additional specification
to identify ‘domestic-born but foreign-trained’ doctors
and nurses
• Frequency: This new module may be included every year
or every three years, depending on assessment of benefits
of regular updating versus data collection burden
Issues for discussion
• COMMENT on the results from 2013-14
OECD pilot data collection on foreigntrained doctors and nurses
• COMMENT on proposal to add a new
module on health workforce migration in
the 2015 Joint Questionnaire