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Junior doctors’ medical specialty and practice location choice: simulating policies to overcome regional inequalities

Author

Listed:
  • Pedro Ramos

    (Universidade de São Paulo
    University of Porto)

  • Hélio Alves

    (University of Porto)

  • Paulo Guimarães

    (Bank of Portugal
    University of Porto)

  • Maria A. Ferreira

    (University of Porto)

Abstract

There are nowadays over 1 million Portuguese who lack a primary care physician. By applying a discrete choice experiment to a large representative sample of Portuguese junior doctors (N = 503) in 2014, we provide an indication that this shortage may be addressed with a careful policy design that mixes pecuniary and non-pecuniary incentives for these junior physicians. According to our simulations, a policy that includes such incentives may increase uptake of general practitioners (GPs) in rural areas from 18% to 30%. Marginal wages estimated from our model are realistic and close to market prices: an extra hour of work would require an hourly wage of 16.5€; moving to an inland rural setting would involve an increase in monthly income of 1.150€ (almost doubling residents’ current income); a shift to a GP career would imply an 849€ increase in monthly income. Additional opportunities to work outside the National Health Service overcome an income reduction of 433€. Our simulation predicts that an income increase of 350€ would lead to a 3 percentage point increase in choice probability, which implies an income elasticity of 3.37, a higher estimation compared to previous studies.

Suggested Citation

  • Pedro Ramos & Hélio Alves & Paulo Guimarães & Maria A. Ferreira, 2017. "Junior doctors’ medical specialty and practice location choice: simulating policies to overcome regional inequalities," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(8), pages 1013-1030, November.
    • Handle: RePEc:spr:eujhec:v:18:y:2017:i:8:d:10.1007_s10198-016-0846-6
    DOI: 10.1007/s10198-016-0846-6
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    More about this item

    Keywords

    Medical specialty choice; Discrete choice experiment; Location decision; Rural uptake policies; Portugal;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J3 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs

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