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On the Dynamics of Physician Density; Theory and Empirical Evidence for Switzerland

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  • Sandra Nocera
  • Gabrielle Wanzenried
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    Abstract

    This paper analyzes the geographical distribution of physicians across the 26 cantons of Switzerland from 1960 to 1998. We use a dynamic location model to explain physicians' choice for their practices by considering market characteristics and medical infrastructure. Our panel data analysis indicates that physicians avoid areas where physician density has reached a certain level. Also, specialists' services may sometimes be substituted for those provided by general practitioners. These results do not support the common reproach that the unequal geographic distribution of physicians necessarily reflects market failure. Finally, as physician densities converge over time, a more equal distribution in the cantons results.

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    File URL: http://www.vwl.unibe.ch/papers/dp/dp0208.pdf
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    Bibliographic Info

    Paper provided by Universitaet Bern, Departement Volkswirtschaft in its series Diskussionsschriften with number dp0208.

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    Date of creation: Jun 2002
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    Handle: RePEc:ube:dpvwib:dp0208

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    Postal: Schanzeneckstr. 1, PF 8573, CH-3001 Bern
    Phone: 0041 31 631 45 06
    Fax: 41 31 631 37 83
    Web page: http://www.vwi.unibe.ch/content/publikationen/index_eng.html
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    Related research

    Keywords: physician density; market failure; health policy; convergence analysis; panel data;

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    1. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456.
    2. J Hurley, 1990. "Simulated Effects of Incomes-based Policies on the Distribution of Physicians," Centre for Health Economics and Policy Analysis Working Paper Series 11, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    3. De Jaegher, Kris & Jegers, Marc, 2000. "A model of physician behaviour with demand inducement," Journal of Health Economics, Elsevier, vol. 19(2), pages 231-258, March.
    4. 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.
    5. Labelle, Roberta & Stoddart, Greg & Rice, Thomas, 1994. "A re-examination of the meaning and importance of supplier-induced demand," Journal of Health Economics, Elsevier, vol. 13(3), pages 347-368, October.
    6. Bhargava, A & Franzini, L & Narendranathan, W, 1982. "Serial Correlation and the Fixed Effects Model," Review of Economic Studies, Wiley Blackwell, vol. 49(4), pages 533-49, October.
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