Barefoot and Footloose Doctors: Optimal Resource Allocation in Developing Countries with Medical Migration

34 Pages Posted: 27 Oct 2013 Last revised: 3 Jun 2015

See all articles by John E. Roemer

John E. Roemer

Yale University - Department of Political Science; Yale University - Cowles Foundation

Pedro Rosa Dias

University of Sussex - Department of Economics

Date Written: June 2, 2015

Abstract

In light of the shortage of healthcare professionals, many developing countries operate a defacto 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 more than the training cost of emigrating physicians in order to restore aggregate population health to the pre-migration level, assuming that there are increasing marginal costs in involved in replacing migrating physicians.

Keywords: Community health workers, Burden of disease, Developing countries, Migration, Optimal resource allocation

JEL Classification: I15, I18, O15

Suggested Citation

Roemer, John E. and Rosa Dias, Pedro, Barefoot and Footloose Doctors: Optimal Resource Allocation in Developing Countries with Medical Migration (June 2, 2015). Cowles Foundation Discussion Paper No. 1922. Available at SSRN: https://ssrn.com/abstract=2345380

John E. Roemer (Contact Author)

Yale University - Department of Political Science ( email )

Box 208269
New Haven, DC 06520-8269
United States
203-432-5249 (Phone)
203-432-6196 (Fax)

HOME PAGE: http://pantheon.yale.edu/~jer39/

Yale University - Cowles Foundation

Box 208281
New Haven, CT 06520-8281
United States

Pedro Rosa Dias

University of Sussex - Department of Economics ( email )

School of Social Sciences & Cultural Studies
Falmer, Brighton, BN1 9QN
United Kingdom

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