{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T17:25:49Z","timestamp":1754155549545,"version":"3.41.2"},"reference-count":57,"publisher":"Emerald","issue":"5","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["K"],"published-print":{"date-parts":[[2024,4,5]]},"abstract":"<jats:sec><jats:title content-type=\"abstract-subheading\">Purpose<\/jats:title><jats:p>The migration of physicians is a global interest, causing imbalances between developed and developing countries. Romania is one of Europe's major providers of physicians, not because there is a surplus, but because physicians are drawn to places with better living and working conditions. Medicine in Romania is increasingly highly advanced, and Romanian physicians are well appreciated all over the world. Despite being one of the countries with the most medical graduates in the world, Romania is suffering a doctor exodus. After joining the EU, the problem of physician migration became widespread, resulting in a deficient and inefficient healthcare system. Therefore, the purpose of this study is to estimate the losses registered by Romania because of physicians' decision to migrate.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Design\/methodology\/approach<\/jats:title><jats:p>These losses were calculated in two ways: utilizing the statistical life value and the amount of money invested in training a medical graduate.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Findings<\/jats:title><jats:p>According to the findings, the losses in 2018 were 104.16 million euros, approximately 0.12% of GDP.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Originality\/value<\/jats:title><jats:p>The originality of this paper consists in data, being provided by the College of Physicians from Romania and the method used, this study being the only one that estimates the cost of Romanian physicians' migration. The paper adds to existing knowledge an empirical results regarding quantifying the value reflecting the departure of physicians, using value of statistical life and the amount of money invested in preparing a medical graduate.<\/jats:p><\/jats:sec>","DOI":"10.1108\/k-07-2022-0931","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T04:35:44Z","timestamp":1677558944000},"page":"1593-1606","source":"Crossref","is-referenced-by-count":0,"title":["What price Romania has to pay for being one of the main providers of physicians in Europe?"],"prefix":"10.1108","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1727-0114","authenticated-orcid":false,"given":"Simona Andreea","family":"Apostu","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1252-9334","authenticated-orcid":false,"given":"Bulent","family":"Akkaya","sequence":"additional","affiliation":[]}],"member":"140","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"unstructured":"Alkir, S.R., Meinzen-Dick, A.P., Agnes, R., Quisumbing, G.S. and Vaz, A. (2008), \u201cThe women's empowerment in agriculture index\u201d, Discussion Paper 01240, International Food Policy Research Institute (IFPRI), Washington, DC, (2012), available at: http:\/\/citeseerx.ist.psu.edu\/viewdoc\/download?doi\u00bc10.1.1.828.2955&rep\u00bcrep1&type\u00bcpdf (accessed 30 August 2020).","key":"key2024040505464544200_ref001"},{"issue":"1","key":"key2024040505464544200_ref002","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1002\/chp.4","article-title":"Physician migration: donor country impact","volume":"25","year":"2005","journal-title":"Journal of Continuing Education in the Health Professions"},{"key":"key2024040505464544200_ref003","article-title":"Human resources and health outcomes: cross-country econometric study","volume":"364","year":"2004","journal-title":"The Lancet"},{"unstructured":"Apostu, S.A., Roman, M. and Vasile, V. (2020), \u201cPhysicians\u2019migration from Romania. Recent evidence from administrative data\u201d, New Trends in Sustainable Business and Consumption.","key":"key2024040505464544200_ref004"},{"issue":"2","key":"key2024040505464544200_ref005","first-page":"71","article-title":"Unemployment in Romania. A retrospective analysis (1991\u20132005)","year":"2006","journal-title":"Theoretical and Applied Economics Magazine"},{"unstructured":"Baubock, R. (1995), in Cohen, R. (Ed.), Ethical Problems of Immigration Control and Citizenship. Cambridge Survey of World Migration, Cambridge University Press, Cambridge.","key":"key2024040505464544200_ref006"},{"issue":"17","key":"key2024040505464544200_ref007","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1056\/NEJMhpr033066","article-title":"New steam from an old cauldron. The physician-supply debate","volume":"350","year":"2004","journal-title":"New England Journal of Medicine"},{"unstructured":"Buchan, J. (2006), \u201cMigration of health workers in Europe: policy problem or policy solution?\u201d, in Dubois, C.A., McKee, M. and Nolte, E. (Eds), Human Resources for Health in Europe, Open University Press, Berkshire \u2013 New York, pp.\u00a041-62.","key":"key2024040505464544200_ref008"},{"key":"key2024040505464544200_ref009","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1111\/jan.12138","article-title":"What explains the distribution of doctors and nurses in different countries, and does it matter for health outcomes?","volume":"69","year":"2013","journal-title":"Journal of Advanced Nursing"},{"key":"key2024040505464544200_ref010","first-page":"626","article-title":"Global interaction, global inequality, and migration of the highly trained to the US","volume":"32","year":"1999","journal-title":"International Migration Review"},{"key":"key2024040505464544200_ref011","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s12960-017-0239-7","article-title":"Factors influencing trainee doctor emigration in a high income country: a mixed methods study","volume":"15","year":"2017","journal-title":"Human Resources for Health"},{"issue":"1","key":"key2024040505464544200_ref012","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1146\/annurev.resource.012809.103949","article-title":"Valuing mortality risk reductions: progress and challenges","volume":"3","year":"2011","journal-title":"Annual Review of Resource Economics"},{"unstructured":"Dartmouth Medical School (1998), \u201cCenter for the evaluative clinical sciences, the dartmouth atlas of health care 1998\u201d, in Wennberg, J.E. (Ed.), The Dartmouth Atlas of Health Care in the United States, American Hospital Publishing, Chicago.","key":"key2024040505464544200_ref013"},{"key":"key2024040505464544200_ref014","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s12960-016-0169-9","article-title":"Physicians' job satisfaction and motivation in a public academic hospital","volume":"14","year":"2016","journal-title":"Human Resources for Health"},{"key":"key2024040505464544200_ref015","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.3390\/ijerph15112546","article-title":"Factors associated with satisfaction of hospital physicians: a systematic review on European data","volume":"15","year":"2018","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"1","key":"key2024040505464544200_ref016","first-page":"43","article-title":"Exploring satisfaction and migration intentions of physicians in three university hospitals in Poland","volume":"17","year":"2020","journal-title":"International Journal of Environmental Research and Public Health"},{"unstructured":"Dubois, C.A., McKee, M. and Nolte, E. (2006), \u201cMoving forward: building a strategic framework for the development of the health care workforce\u201d, in Dubois, C.A., McKee, M. and Nolte, E. (Eds), Human Resources for Health in Europe, Open University Press, Berkshire \u2013 New York, pp.\u00a0235-240.","key":"key2024040505464544200_ref017"},{"key":"key2024040505464544200_ref018","first-page":"12","article-title":"Impact, regulation and health policy implications of physician migration in OECD countries","volume":"1","year":"2004","journal-title":"Human Resources for Health"},{"key":"key2024040505464544200_ref019","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.genm.2009.04.006","article-title":"Survey on recent suicidal ideation among female university hospital physicians in Sweden and Italy (TheHOUPE Study): cross-sectional associations with work stressors","volume":"6","year":"2009","journal-title":"Gender Medicine"},{"key":"key2024040505464544200_ref020","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1186\/1472-6963-7-201","article-title":"Physicians' migration in Europe: an overview of the current situation","volume":"7","year":"2007","journal-title":"BMC Health Services Research"},{"key":"key2024040505464544200_ref021","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1001\/jama.1996.03540220035027","article-title":"Benchmarking the US physician workforce. An alternative to needs-based or demand-based planning","volume":"276","year":"1996","journal-title":"JAMA"},{"issue":"1","key":"key2024040505464544200_ref022","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1478-4491-2-17","article-title":"The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain","volume":"2","year":"2004","journal-title":"Human Resources for Health"},{"unstructured":"Hamilton, K. and Yau, J. (2006), \u201cThe global tug-of-war for health care workers\u201d, [monograph on the Internet], Migration Policy Institute, Washington, available at: http:\/\/www.migrationinformation.org\/Feature\/display.cfm?id=271 (accessed 15 March 2021).","key":"key2024040505464544200_ref023"},{"volume-title":"NEXT Scientific Report","year":"2005","key":"key2024040505464544200_ref024"},{"issue":"4","key":"key2024040505464544200_ref025","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.ijresmar.2003.03.001","article-title":"Building strong brands in asia: selecting the visual components of image to maximize brand strength","volume":"20","year":"2003","journal-title":"International Journal of Research in Marketing"},{"issue":"4","key":"key2024040505464544200_ref026","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1177\/003335490912400411","article-title":"Mortality in appalachian coal mining regions: the value of statistical life lost","volume":"124","year":"2009","journal-title":"Public Health Reports"},{"issue":"2-3","key":"key2024040505464544200_ref027","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.healthpol.2012.09.007","article-title":"The value of a statistical life in Sweden: a review of the empirical literature","volume":"108","year":"2012","journal-title":"Health Policy"},{"unstructured":"Jakubowski, E. and Hess, R. (2004), in McKee, M., MacLehose, L. and Nolte, E. (Eds), The Market for Physicians. Health Policy and European Union Enlargement, Open University Press, Berkshire, pp.\u00a0131-142.","key":"key2024040505464544200_ref028"},{"key":"key2024040505464544200_ref029","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1215\/03616878-2008-035","article-title":"Job satisfaction and motivation among physicians in academic medical centers: insights from a cross-national study","volume":"33","year":"2008","journal-title":"Journal of Health Politics Policy and Law"},{"volume-title":"Human Resources for Health: Overcoming the Crisis","year":"2004","author":"Joint Learning Initiative","key":"key2024040505464544200_ref030"},{"issue":"6","key":"key2024040505464544200_ref031","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.cardfail.2020.05.008","article-title":"Coronavirus disease-2019 in heart transplant recipients in southeastern Michigan: a case series","volume":"26","year":"2020","journal-title":"Journal of Cardiac Failure"},{"key":"key2024040505464544200_ref032","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jclinane.2006.08.014","article-title":"Work stress and gender-dependent coping strategies in anesthesiologists at a university hospital","volume":"19","year":"2007","journal-title":"Journal of Clinical Anesthesia"},{"unstructured":"Kniesner, T.J. and Viscusi, W.K. (2019), \u201cThe value of a statistical life (April 10, 2019)\u201d, Forthcoming, Oxford Research Encyclopedia of Economics and Finance, Vanderbilt Law Research Paper No. 19-15 (2019), SSRN, available at: https:\/\/ssrn.com\/abstract=3379967 (accessed 12 March 2021).","key":"key2024040505464544200_ref033"},{"key":"key2024040505464544200_ref034","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s00038-006-5021-x","article-title":"Job satisfaction and the work situation of physicians: a survey at a German university hospital","volume":"52","year":"2007","journal-title":"International Journal of Public Health"},{"key":"key2024040505464544200_ref035","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1002\/smi.2479","article-title":"Associations between confidentiality requirements, support seeking and burnout among university hospital physicians in Norway, Sweden, Iceland and Italy (the HOUPE study)","volume":"29","year":"2013","journal-title":"Stress Health"},{"key":"key2024040505464544200_ref036","doi-asserted-by":"crossref","first-page":"431","DOI":"10.2307\/2938462","article-title":"Theories of international migration: a review and appraisal","volume":"19","year":"1993","journal-title":"Population and Development Review"},{"issue":"3","key":"key2024040505464544200_ref037","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/ije\/7.3.207","article-title":"Migration of physicians and nurses: a world wide picture","volume":"7","year":"1978","journal-title":"International Journal of Epidemiology"},{"year":"2018","author":"Ministry of Health","key":"key2024040505464544200_ref060"},{"year":"2019","author":"Ministry of Health","key":"key2024040505464544200_ref058"},{"unstructured":"Najwyz \u0307sza Izba Kontroli (NIK) (2016), \u201cKszta\u0142ceniei Przygotowanie Zawodowe Kadr Medycznych. Report Dedicatedto Training of Medical Staff\u201d, The Polish Supreme Audit Office (NIK), Warszawa, available at: https:\/\/www.nik.gov.pl\/plik\/id,10242,vp,12565.pdf (accessed 20 May 2022).","key":"key2024040505464544200_ref038"},{"key":"key2024040505464544200_ref039","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1179\/oeh.2010.16.3.330","article-title":"Job stressors among female physicians: relation to having a clinical diagnosis of hypertension","volume":"16","year":"2010","journal-title":"The International Journal of Occupational and Environmental Medicine"},{"unstructured":"Nicholas, S. (2004), \u201cThe challenges of the free movement of health professionals\u201d, in McKee, M., MacLehose, L. and Nolte, E. (Eds), Health Policy and European Union Enlargement, Open University Press, Berkshire, pp.\u00a082-108.","key":"key2024040505464544200_ref040"},{"year":"1991","author":"NIS","key":"key2024040505464544200_ref056"},{"year":"1993","author":"NIS","key":"key2024040505464544200_ref057"},{"unstructured":"Organization for Economic Co-operation and Development OECD (2005), \u201cAnnual report 2005\u201d, available at: https:\/\/www.oecd.org\/about\/34711139.pdf (accessed 2 May 2021).","key":"key2024040505464544200_ref041"},{"key":"key2024040505464544200_ref042","first-page":"1238","article-title":"Exploring physicians' dissatisfaction and work-related stress: development of the PhyDis Scale","volume":"7","year":"2016","journal-title":"Frontiers in Psychology"},{"year":"2022","key":"key2024040505464544200_ref059"},{"key":"key2024040505464544200_ref043","article-title":"The impact of physician migration on mortality in low and middle-income countries: an economic modelling study","volume":"5","year":"2020","journal-title":"BMJ Global Health"},{"key":"key2024040505464544200_ref044","doi-asserted-by":"crossref","first-page":"516","DOI":"10.2471\/BLT.07.046474","article-title":"Forecasting the global shortage of physicians: an economic- and needs-based approach","volume":"86","year":"2008","journal-title":"Bulletin of the World Health Organization"},{"volume-title":"Matching Supply with Demand for the Services of Physicians and Nurses. The OECD Health Project. Towards High Performing Health Systems. Policy Studies","year":"2004","key":"key2024040505464544200_ref045"},{"key":"key2024040505464544200_ref046","first-page":"173","article-title":"The new economics of labor migration","volume":"75","year":"1985","journal-title":"American Economic Review"},{"key":"key2024040505464544200_ref047","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1093\/occmed\/kqr196","article-title":"Stress perception among employees in a French University Hospital","volume":"62","year":"2012","journal-title":"Occupational Medicine"},{"key":"key2024040505464544200_ref048","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/EJA.0b013e32835d2db2","article-title":"Influence of latent risk factors on job satisfaction, job stress and intention to leave in anaesthesia teams: a cross-sectional survey","volume":"30","year":"2013","journal-title":"European Journal of Anaesthesiology"},{"key":"key2024040505464544200_ref049","first-page":"812","article-title":"Long term regional migration patterns of physicians over the course of their active practice careers","volume":"7","year":"2007","journal-title":"Rural and Remote Health"},{"unstructured":"Viscusi, W.K. and Masterman, C. (2017), \u201cIncome elasticity and the global value of a statistical life\u201d, (May 10, 2017), Vanderbilt Law Research Paper No. 17-29 (2017), SSRN, available at: https:\/\/ssrn.com\/abstract=2975466 (accessed 12 March 2021).","key":"key2024040505464544200_ref050"},{"key":"key2024040505464544200_ref051","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1016\/S0140-6736(09)61424-0","article-title":"Physician wellness: a missing quality indicator","volume":"374","year":"2009","journal-title":"Lancet"},{"key":"key2024040505464544200_ref055","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1017\/bca.2018.26","article-title":"Valuing mortality risk reductions in global benefit-cost analysis","volume":"10","year":"2019","journal-title":"Journal of Benefit-Cost Analysis"}],"container-title":["Kybernetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/K-07-2022-0931\/full\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/K-07-2022-0931\/full\/html","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T21:49:26Z","timestamp":1753393766000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.emerald.com\/k\/article\/53\/5\/1593-1606\/1212751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,28]]},"references-count":57,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,2,28]]},"published-print":{"date-parts":[[2024,4,5]]}},"alternative-id":["10.1108\/K-07-2022-0931"],"URL":"https:\/\/doi.org\/10.1108\/k-07-2022-0931","relation":{},"ISSN":["0368-492X"],"issn-type":[{"type":"print","value":"0368-492X"}],"subject":[],"published":{"date-parts":[[2023,2,28]]}}}