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Getting Doctors into the Bush: General Practitioners' Preferences for Rural Location

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Author Info

  • Anthony Scott

    ()
    (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne)

  • Julia Lane

    (Department of Economics, University of Manitoba)

  • John Humphreys

    (School of Rural Health, Monash University)

  • Catherine Joyce

    (Department of Eipdemiology and Preventive Medicine, Monash University)

  • Guyonne Kalb

    ()
    (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne)

  • Sung-Hee Jeon
  • Matthew McGrail

    (School of Rural Health, Monash University)

Abstract

A key policy issue in many countries is the maldistribution of doctors across geographic areas, which has important effects on equity of access and health care costs. Many government programs and incentive schemes have been established to encourage doctors to practise in rural areas. However, there is little robust evidence of the effectiveness of such incentive schemes. The aim of this study is to examine the preferences of general practitioners (GPs) for rural location using a discrete choice experiment. This is used to estimate the probabilities of moving to a rural area, and the size of financial incentives GPs would require to move there. GPs were asked to choose between two job options or to stay at their current job as part of the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey of doctors. 3,727 GPs completed the experiment. Sixty five per cent of GPs chose to stay where they were in all choices presented to them. Moving to an inland town with less than 5,000 population and reasonable levels of other job characteristics would require incentives equivalent to 64% of current average annual personal earnings ($116,000). Moving to a town with a population between 5,000 and 20,000 people would require incentives of at least 37% of current annual earnings, around $68,000. The size of incentives depend not only on the area but also on the characteristics of the job. The least attractive rural job package would require incentives of at least 130% of annual earnings, around $237,000.

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Bibliographic Info

Paper provided by Melbourne Institute of Applied Economic and Social Research, The University of Melbourne in its series Melbourne Institute Working Paper Series with number wp2012n13.

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Length: 36 pages
Date of creation: Jul 2012
Date of revision:
Handle: RePEc:iae:iaewps:wp2012n13

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Postal: Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Victoria 3010 Australia
Phone: +61 3 8344 2100
Fax: +61 3 8344 2111
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Web page: http://www.melbourneinstitute.com/
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Keywords: Discrete choice experiment; incentives; physicians; primary care; rural;

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References

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  1. Chomitz, Kenneth M. & Setiadi, Gunawan & Azwar, Azrul & Ismail, Nusye & Widiyarti, 1998. "What do doctors want? developing incentives for doctors to serve in Indonesia's rural and remote areas," Policy Research Working Paper Series 1888, The World Bank.
  2. David E. Bloom & Till Barnighausen, 2009. "Financial incentives for return of service in underserved areas: a systematic review," PGDA Working Papers 4309, Program on the Global Demography of Aging.
  3. Heiligers, Phil J. M. & Hingstman, L., 2000. "Career preferences and the work-family balance in medicine: gender differences among medical specialists," Social Science & Medicine, Elsevier, vol. 50(9), pages 1235-1246, May.
  4. Terence Chai Cheng & Anthony Scott & Sungā€Hee Jeon & Guyonne Kalb & John Humphreys & Catherine Joyce, 2012. "What Factors Influence The Earnings Of General Practitioners And Medical Specialists? Evidence From The Medicine In Australia: Balancing Employment And Life Survey," Health Economics, John Wiley & Sons, Ltd., vol. 21(11), pages 1300-1317, November.
  5. Emily Lancsar & Elizabeth Savage, 2004. "Deriving welfare measures from discrete choice experiments: inconsistency between current methods and random utility and welfare theory," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 901-907.
  6. Julie Riise Kolstad, 2011. "How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 196-211, 02.
  7. Denzil G. Fiebig & Michael P. Keane & Jordan Louviere & Nada Wasi, 2010. "The Generalized Multinomial Logit Model: Accounting for Scale and Coefficient Heterogeneity," Marketing Science, INFORMS, vol. 29(3), pages 393-421, 05-06.
  8. Hancock, Christine & Steinbach, Alan & Nesbitt, Thomas S. & Adler, Shelley R. & Auerswald, Colette L., 2009. "Why doctors choose small towns: A developmental model of rural physician recruitment and retention," Social Science & Medicine, Elsevier, vol. 69(9), pages 1368-1376, November.
  9. Scott, Anthony, 2001. "Eliciting GPs' preferences for pecuniary and non-pecuniary job characteristics," Journal of Health Economics, Elsevier, vol. 20(3), pages 329-347, May.
  10. Hole, Arne Risa & Kolstad, Julie Riise, 2010. "Mixed logit estimation of willingness to pay distributions: a comparison of models in preference and WTP space using data from a health-related choice experiment," Working Papers in Economics 03/10, University of Bergen, Department of Economics.
  11. Wenda Yan & Terence Chai Cheng & Anthony Scott & Catherine M. Joyce & John Humphreys & Guyonne Kalb & Anne Leahy, 2011. "Medicine in Australia: Balancing Employment and Life (MABEL)," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 44(1), pages 102-112, 03.
  12. Kolstad, Julie Riise, 2008. "How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania," Working Papers in Economics 15/08, University of Bergen, Department of Economics.
  13. Scarpa, R. & Thiene, M. & Train, K., 2008. "Appendix to Utility in WTP space: a tool to address confounding random scale effects in destination choice to the Alps," American Journal of Agricultural Economics Appendices, Agricultural and Applied Economics Association, vol. 90(4), November.
  14. Riccardo Scarpa & Mara Thiene & Kenneth Train, 2008. "Utility in Willingness to Pay Space: A Tool to Address Confounding Random Scale Effects in Destination Choice to the Alps," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 90(4), pages 994-1010.
  15. Mickael Bech & Dorte Gyrd-Hansen, 2005. "Effects coding in discrete choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1079-1083.
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