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      Peer Review of “Medical Brain Drain From Southeastern Europe: Using Digital Demography to Forecast Health Worker Emigration”

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          Medical Brain Drain From Southeastern Europe: Using Digital Demography to Forecast Health Worker Emigration

          Background This paper shows that the tools of digital demography, such as Google Trends, can be used for determining, estimating, and predicting the migration of health care workers (HWs), in this case, from Croatia and the Western Balkans (WB) to Germany and Austria. Objective This study aims to test the usefulness of Google Trends indexes to forecast HW migration from Croatia and the WB to Germany and Austria. The paper analyzes recent trends in HW mobility in Europe and focuses specifically on mobility patterns among medical doctors and nurses using digital demography. Without increased emigration in the last 10 years, Croatia and the WB would have 50% more HWs today, and this staff is now crucial in the fight against a pandemic. Furthermore, the COVID-19 pandemic contributed to the increase in emigration. Methods A particular problem in analyzing the emigration of HCWs from Croatia and the WB is that there is no system for monitoring this process. Official data is up to 3 years late and exists only for persons deregistered from the state system. Furthermore, during the pandemic, the “normal” ways of data collection are simply too slow. The primary methodological concept of our approach is to monitor the digital trace of language searches with the Google Trends analytical tool. To standardize the data, we requested the data from January 2010 to December 2020 and divided the keyword frequency for each migration-related query. We compared this search frequency index with official statistics to prove the significance of the results and correlations, and test the model’s predictive potential. Results All tested migration-related search queries, which indicate HCWs’ emigration planning, showed a positive linear association between Google index and data from official statistics (Organisation for Economic Co-operation and Development: Serbia R 2 =0.3381, Bosnia and Herzegovina [B&H] R 2 =0.2722, Croatia R 2 =0.4515). Migration-related search activities such as “job application + nurses” from Croatia correlate strongly with official German data for emigrated HWs from Croatia, Serbia, and B&H. Decreases in Google searches were correlated with the decrease in the emigration of HWs. Thus, this method allows reliable forecasts for the future. Conclusions This paper highlights that the World Health Organization’s list of countries with HWs shortages should be updated to include Croatia and the countries from the WB. The issue of the European Union drawing HWs from the EU periphery (Croatia) and nearby countries (B&H, Serbia) clearly shows a clash between the EU freedom of movement and the right to health care and a need to ensure a health care workforce in all European regions. Understanding why HWs emigrate from Croatia and the WB, and the consequences of this process are crucial to enabling state agencies and governments to develop optimal intervention strategies to retain medical staff. The benefit of this method is reliable estimates that can enable a better response to a possible shortage of HWs and protect the functioning of the health system. The freedom of movement of workers in the EU must be supplemented with a common pension and health care system in the EU.

            Author and article information

            Journal
            JMIRx Med
            JMIRx Med
            JMIRxMed
            JMIRx Med
            JMIR Publications (Toronto, Canada )
            2563-6316
            Oct-Dec 2021
            30 November 2021
            : 2
            : 4
            : e34079
            Affiliations
            [1 ] Department for Demography and Croatian Emigration Faculty of Croatian Studies University of Zagreb Zagreb Croatia
            Author information
            https://orcid.org/0000-0002-3131-6679
            Article
            v2i4e34079
            10.2196/34079
            10414510
            cc73236b-ed16-498d-b9dc-11799e28571c
            ©Monika Komušanac. Originally published in JMIRx Med (https://med.jmirx.org), 30.11.2021.

            This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIRx Med, is properly cited. The complete bibliographic information, a link to the original publication on https://med.jmirx.org/, as well as this copyright and license information must be included.

            History
            : 5 October 2021
            : 5 October 2021
            Categories
            Peer-Review Report
            Peer-Review Report

            digital demography,google trends,the emigration of doctors and nurses,medical brain drain,croatia,demography,brain drain,emigration,doctors,nurses,health care workers,health professionals,health systems,jobs,germany,personnel,migration,workforce,medical professionals

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