Demographic and geographic determinants of regional physician supply
AbstractAgainst 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 structure, fertility and migration) and geographic determinants. Particular attention is given (i) to local population change as a predictor of future 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 profitability of treating the local population, and (iii) to cross-regional correlations in physician supply. Using regional data for Germany, we examine econometrically the determinants of regional physician supply. We find 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 effect arises only for the share 20- in regions with agglomeration character. Net migration and natural balance turn out to be significant positive as long-run determinants only, indicating thus their role as predictors of future demand. On average, cross-regional spillovers in demand do not seem to be important determinants of regional supply. --
Download InfoIf 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 InfoPaper provided by University of Rostock, Institute of Economics in its series Thuenen-Series of Applied Economic Theory with number 105.
Date of creation: 2009
Date of revision:
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; Spatio-temporal Models
- 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
Please 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.:
- 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.
- 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.
- 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.
- Samson, Anne-Laure & Dormont, Brigitte, 2008.
"Medical demography and intergenerational inequalities in general practitioners' earnings,"
Economics Papers from University Paris Dauphine
123456789/1624, Paris Dauphine University.
- 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.
- 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 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Gravelle, Hugh, 1999. "Capitation contracts: access and quality," Journal of Health Economics, Elsevier, vol. 18(3), pages 315-340, June.
- Brigitte Dormont & Michel Grignon & Hélène Huber, 2006.
"Health expenditure growth : reassessing the threat of ageing,"
- 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.
- Dionne, Georges & Langlois, Alain & Lemire, Nicole, 1987. "More on the geographical distribution of physicians," Journal of Health Economics, Elsevier, vol. 6(4), pages 365-374, December.
- Huber, Hélène & Grignon, Michel & Dormont, Brigitte, 2006. "Health expenditure growth : reassessing the threat of ageing," Economics Papers from University Paris Dauphine 123456789/3881, Paris Dauphine University.
- 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.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (ZBW - German National Library of Economics).
If references are entirely missing, you can add them using this form.