Health workforce remuneration

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Download AIAS Working Paper 11-111. Amsterdam, the Netherlands: University of Amsterdam.

Abstract

This article focuses on remuneration in the Human Resources for Health (HRH), comparing wage levels, ranking and dispersion of 16 HRH occupations in 20 countries (Argentina, Belarus, Belgium, Brazil, Chile, Colombia, Czech Republic, Finland, Germany, India, Mexico, Netherlands, Poland, Russian Federation, South-Africa, Spain, Sweden, Ukraine, United Kingdom, United States). Research questions asked are to what extent are the wage rankings, wage dispersion, and standardized wage levels are similar between the 16 occupational groups in the HRH workforce across countries. The pooled data from the continuous, worldwide, multilingual WageIndicator web-survey between 2008 and 2011Q1 have been analysed (N= 38,799). Hourly wages expressed in standardized USD, all controlled for PPP and then indexed to 2011 levels. The findings show that the Medical Doctors have overall the highest median wages and they have so in 11 of 20 countries, while the Personal Care Workers have overall lowest wages and they have so in 9 of 20 countries. Health Care Managers lower earnings than Medical Doctors, but in 5 of 20 countries they have higher earnings (BLR, CZE, POL, RUS, UKR). The wage levels of Nursing & Midwifery Professionals vary largely across countries. The correlation of the overall ranking to the national ranking is more than .7 in 7 of 20 countries. The wage dispersion is defined as the ratio of the highest to the lowest median earnings in an occupation in a country. It is highest in Brazil (7.0), and lowest in Sweden, Germany, Poland, and Argentina. When comparing wage levels in occupations across countries, the largest wage differences for the Medical Doctors: the Ukraine doctor earns 19 times less compared to the US doctor. A correlation between country-level earnings and wage differentials across countries reveals that the higher the median wages in an occupation, the higher the wage difference across countries (r=.9). In conclusion, this article breaks new ground by investigating for the first time the wage levels, ranking and dispersion of occupational groups in the HRH workforce across countries. Findings illustrate that the assumption of similarity in cross-country wage ranking, wage dispersion, and purchasing power adjusted wage levels does not hold. These findings help to explain the complexity of migratory paths seen.