Trickledown effect on medical migration in Brazilian municipalities

Abstract

The article seeks to analyze medical migration by identifying the trickledown effect in Brazilian municipalities for general practitioners and specialists. To this end, it uses data from the 2000 and 2010 Censo and the two-level hierarchical model, the first with individual data and the second with municipal data (incorporating spatial lags). As a result, there is no trickledown effect for medical migration, both for generalists (who are randomly dispersed by the municipalities) and for specialists, however the explained variance of the intercept confirms the importance of including the individual, municipal and spatial variables. General practitioners seek regions with a shortage of medical labor. These regions are marked by the lack of infrastructure such as low number of beds, poor urbanization, and lower population density. This result is positive, as it helps to increase the care of the poorest and reduce regional inequalities.