Demographic and Geographic Determinants of Regional Physician Supply
Abstract
Against the backdrop of an ongoing debate in most countries about the geographic (mal-)distribution of physician practices, we develop a theoretical and empirical framework to analyze how physician supply at regional level depends on demographic (population size, age struc- ture, fertility and migration) and geographic determinants. Particular attention is given (i) to local population change as a predictor of fu- ture demand for physician services, (ii) to the way in which the age- structure of the (potential patient) population and regional structure interact in shaping the pro�tability of treating the local population, and (iii) to cross-regional correlations in physician supply. Using re- gional data for Germany, we examine econometrically the determinants of regional physician supply. We �nd it to be negatively related to both the population share 60+ and the population share 20- in rural areas. While both population shares tend to have a less negative impact in urban areas, a pronounced positive e¤ect arises only for the share 20- in regions with agglomeration character. Net migration and natural balance turn out to be signi�cant positive as long-run determinants only, indicating thus their role as predictors of future demand. On av- erage, cross-regional spillovers in demand do not seem to be important determinants of regional supply.Download Info
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.Bibliographic Info
Paper provided by University of Rostock, Institute of Economics, Germany in its series Thuenen-Series of Applied Economic Theory with number 105.Length:
Date of creation: 2009
Date of revision:
Handle: RePEc:ros:wpaper:105
Contact details of provider:
Postal: Ulmenstr. 69, 18057 Rostock
Phone: (0381)498-4310
Fax: (0381)498-4310
Web page: http://www.wiwi.uni-rostock.de/vwl/
More information through EDIRC
Related research
Keywords: age structure; physician supply; regional population ageing; regional migration; overlapping generations; panel data; spatial model;Find related papers by JEL classification:
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
- J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
- J10 - Labor and Demographic Economics - - Demographic Economics - - - General
- R23 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Regional Migration; Regional Labor Markets; Population
- C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Longitudinal Data; Spatial Time Series
- C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models
This paper has been announced in the following NEP Reports:
- NEP-AGE-2009-08-02 (Economics of Ageing)
- NEP-ALL-2009-08-02 (All new papers)
- NEP-GEO-2009-08-02 (Economic Geography)
- NEP-MIG-2009-08-02 (Economics of Human Migration)
- NEP-URE-2009-08-02 (Urban & Real Estate Economics)
References
References listed on IDEASPlease report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Hendrik Jürges, 2007.
"Health insurance status and physician-induced demand for medical services in Germany: new evidence from combined district and individual level data,"
MEA discussion paper series
07119, Munich Center for the Economics of Aging (MEA) at the Max Planck Institute for Social Law and Social Policy.
- Hendrik Jürges, 2007. "Health Insurance Status and Physician-Induced Demand for Medical Services in Germany: New Evidence from Combined District and Individual Level Data," SOEPpapers on Multidisciplinary Panel Data Research 8, DIW Berlin, The German Socio-Economic Panel (SOEP).
- Hendrik Jürges, 2007. "Health Insurance Status and Physician-Induced Demand for Medical Services in Germany: New Evidence from Combined District and Individual Level Data," Discussion Papers of DIW Berlin 689, DIW Berlin, German Institute for Economic Research.
- Brigitte Dormont & Michel Grignon & Hélène Huber, 2006.
"Health expenditure growth : reassessing the threat of ageing,"
Post-Print
halshs-00181605, HAL.
- Brigitte Dormont & Michel Grignon & Hélène Huber, 2006. "Health expenditure growth: reassessing the threat of ageing," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 947-963.
- Yu, Jihai & de Jong, Robert & Lee, Lung-fei, 2008. "Quasi-maximum likelihood estimators for spatial dynamic panel data with fixed effects when both n and T are large," Journal of Econometrics, Elsevier, vol. 146(1), pages 118-134, September.
- Iversen, Tor & Kopperud, Gry Stine, 2009.
"Regulation versus practice - The impact of accessibility on the use of specialist health care in Norway,"
HERO On line Working Paper Series
2005:2, Oslo University, Health Economics Research Programme.
- Tor Iversen & Gry Stine Kopperud, 2005. "Regulation versus practice - the impact of accessibility on the use of specialist health care in Norway," Health Economics, John Wiley & Sons, Ltd., vol. 14(12), pages 1231-1238.
- B. Dormont & A.-L. Samson, 2008.
"Medical demography and intergenerational inequalities in general practitioners' earnings,"
Health Economics,
John Wiley & Sons, Ltd., vol. 17(9), pages 1037-1055.
- Brigitte Dormont & Anne-Laure Samson, 2008. "Medical Demography and Intergenerational Inequalities in General Practitioner's Earnings," IDEP Working Papers 0804, Institut d'economie publique (IDEP), Marseille, France, revised 10 Sep 2008.
- Nuscheler, Robert, 2002.
"Physician reimbursement, time-consistency and the quality of care,"
Discussion Papers, Research Unit: Market Processes and Governance
FS IV 02-16, Social Science Research Center Berlin (WZB).
- Robert Nuscheler, 2003. "Physician Reimbursement, Time-Consistency and the Quality of Care," Journal of Institutional and Theoretical Economics (JITE), Mohr Siebeck, Tübingen, vol. 159(2), pages 302-, June.
- Stewart, Jennifer M., 2001.
"The impact of health status on the duration of unemployment spells and the implications for studies of the impact of unemployment on health status,"
Journal of Health Economics,
Elsevier, vol. 20(5), pages 781-796, September.
- Jennifer Stewart, 1999. "The Impact of Health Status on the Duration of Unemployment Spells and the Implications for Studies of the Impact of Unemployment on Health Status," Working Papers 33, National University of Ireland Galway, Department of Economics, revised 1999.
- David Dranove & Mark Shanley & Carol Simon, 1992. "Is Hospital Competition Wasteful?," RAND Journal of Economics, The RAND Corporation, vol. 23(2), pages 247-262, Summer.
- 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.
- Giuffrida, Antonio & Gravelle, Hugh, 2001. "Inducing or restraining demand: the market for night visits in primary care," Journal of Health Economics, Elsevier, vol. 20(5), pages 755-779, September.
- Bolduc, Denis & Fortin, Bernard & Fournier, Marc-Andre, 1996. "The Effect of Incentive Policies on the Practice Location of Doctors: A Multinomial Probit Analysis," Journal of Labor Economics, University of Chicago Press, vol. 14(4), pages 703-32, October.
- Hingstman, L. & Boon, H., 1989. "Regional dispersion of independent professionals in primary health care in the Netherlands," Social Science & Medicine, Elsevier, vol. 28(2), pages 121-129, January.
- Jean M. Abraham & Martin S. Gaynor & William B. Vogt, 2005.
"Entry and Competition in Local Hospital Markets,"
NBER Working Papers
11649, National Bureau of Economic Research, Inc.
- Jean Abraham & Martin Gaynor & William B. Vogt, 2005. "Entry and Competition in Local Hospital Markets," GSIA Working Papers 1999-E32, Carnegie Mellon University, Tepper School of Business.
- Jean Marie Abraham & Martin Gaynor & William B Vogt, 2003. "Entry and Competition in Local Hospital Markets," The Centre for Market and Public Organisation 03/088, Department of Economics, University of Bristol, UK.
- Lee, Lung-fei & Yu, Jihai, 2010. "A Spatial Dynamic Panel Data Model With Both Time And Individual Fixed Effects," Econometric Theory, Cambridge University Press, vol. 26(02), pages 564-597, April.
- Jeremiah E. Hurley, 1991.
"Physicians' Choices of Specialty, Location, and Mode: A Reexamination within an Interdependent Decision Framework,"
Journal of Human Resources,
University of Wisconsin Press, vol. 26(1), pages 47-71.
- J Hurley, 1991. "Physicians' Choices of Specialty, Location and Mode: A Re-examination Within an Interdependent Decision Framework," Centre for Health Economics and Policy Analysis Working Paper Series 1, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
- Nickell, Stephen J, 1981. "Biases in Dynamic Models with Fixed Effects," Econometrica, Econometric Society, vol. 49(6), pages 1417-26, November.
- Winfried Pohlmeier & Volker Ulrich, 1995. "An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 30(2), pages 339-361.
- Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
- Joseph P. Newhouse & Albert P. Williams & Bruce W. Bennett & William B. Schwartz, 1982. "Does the Geographical Distribution of Physicians Reflect Market Failure?," Bell Journal of Economics, The RAND Corporation, vol. 13(2), pages 493-505, Autumn.
- John C. Driscoll & Aart C. Kraay, 1998. "Consistent Covariance Matrix Estimation With Spatially Dependent Panel Data," The Review of Economics and Statistics, MIT Press, vol. 80(4), pages 549-560, November.
- Gravelle, Hugh, 1999. "Capitation contracts: access and quality," Journal of Health Economics, Elsevier, vol. 18(3), pages 315-340, June.
Citations
Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.Cited by:
- Correia Isabel & Veiga Paula, 2010. "Geographic distribution of physicians in Portugal," The European Journal of Health Economics, Springer, vol. 11(4), pages 383-393, August.
Lists
This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.Statistics
Access and download statisticsCorrections
When requesting a correction, please mention this item's handle: RePEc:ros:wpaper:105For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Doris Neuberger).
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.

