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 R2=0.3381, Bosnia and Herzegovina [B&H] R2=0.2722, Croatia R2=0.4515). Migration-related search activities such as "job application + nurses" from Croatia correlate ...