Medical brain drain from Western Balkan and Croatia to Germany and Austria: an approach to the digital demography

BackgroundIn this paper, we show that the tools of digital demography, such as the Google Trends (GT) can be very useful for determining, estimating, and predicting the migration of healthcare workers as well as for further predictions of the general interest in emigration. ObjectiveThis paper analyses recent trends in the mobility of health workers in Europe and focuses specifically on the patterns of mobility among medical doctors and nurses from Western Balkans and Croatia to Germany and Austria. It identifies the drivers of this mobility and shows how to predict further migration of this stuff. In the last 10 years, every fourth nurse has emigrated from the Croatian health system -to Germany, while according to projections Croatia will lose as much as 1/3 of all doctors in the next five years. MethodsA special problem in the analysis of the emigration of healthcare workers from the Western Balkans and Croatia is the fact that there is no system for monitoring this process. Official data up to three years late, and exist only for persons who have deregistered from the state system. The basic methodological concept of our approach is to monitor the digital trace of language searches with the Google Trends analytical tool (trends.google.com). Initially, keywords were chosen by brainstorming possible words that we believed to be predictive, specific, and common enough for use in the forecasting of migration of healthcare professionals. To standardize the data, we requested the data for the period from Dec. 2015 to Dec. 2020 and divided the keyword frequency for each word giving us a search frequency index. Then we have compared searches with official statistics to prove the significations of results and correlations. ResultsIn Croatia search activities using GT for terms such as Bewerbung" (job application), "Arbeit" (work), "Krankenschwester, Bewerbung" (nurses, job application) correlate strongly with officially Germans data for emigrants from Croatia. The data collected by this method correlate with official data, which allows reliable forecasts for the future. Austria will soon become one of the most desirable emigration destinations for Croats, especially for healthcare workers. Simultaneously, the emigration of Croatian citizens to Germany will continue. ConclusionUnderstanding why health care personnel emigrate from Western Balkans and Croatia and which are the consequences of this process are key to enable state agencies and government to develop optimal intervention strategies to retain medical staff. The benefit of this method is reliable estimates that can enable state agencies and the government to prepare and better respond to a possible shortage of healthcare workers and to protect the functioning of the health system.