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Physician density in a two-tiered health care system

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  • Gächter, Martin
  • Schwazer, Peter
  • Theurl, Engelbert
  • Winner, Hannes

Abstract

We investigate the density of non-contract (private) physicians in a two-tiered health care system, i.e., one with co-existing public and private health care providers. In particular, we analyze how the densities of private and public suppliers of outpatient health care (general practitioners and specialists) are related to each other. Using a panel of 121 Austrian districts between 2002 and 2008, we apply a Hausman–Taylor estimator, which allows to treat each of these densities as endogenous. We find that the density of non-contract specialists is positively associated with the density of non-contract general practitioners, but not significantly related to the density of contract general practitioners. We also observe a negative relationship between the densities of non-contract and contract general practitioners and the ones of non-contract and contract specialists, indicating competitive forces between the private and the public sector of the outpatient health care provision in Austria. Our results contribute to the ongoing debate on the role of non-contract physicians for health care provision in Austria.

Suggested Citation

  • Gächter, Martin & Schwazer, Peter & Theurl, Engelbert & Winner, Hannes, 2012. "Physician density in a two-tiered health care system," Health Policy, Elsevier, vol. 106(3), pages 257-268.
    • Handle: RePEc:eee:hepoli:v:106:y:2012:i:3:p:257-268
    DOI: 10.1016/j.healthpol.2012.04.012
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    3. Gächter, Martin & Schwazer, Peter & Theurl, Engelbert & Winner, Hannes, 2012. "Regional density of private dentists: Empirical evidence from Austria," Working Papers in Economics 2012-8, University of Salzburg.
    4. Martin Gaechter & Peter Schwazer & Engelbert Theurl, 2013. "Entry into the Physicians’ Market: Empirical Evidence from the Outpatient Sector in Austria," DANUBE: Law and Economics Review, European Association Comenius - EACO, issue 4, pages 245-260, December.
    5. Mougeot, Michel & Naegelen, Florence, 2018. "Achieving a fair geographical distribution of health-care resources," Regional Science and Urban Economics, Elsevier, vol. 70(C), pages 384-392.
    6. Michael Kuhn & Robert Nuscheler, 2020. "Saving the public from the private? Incentives and outcomes in dual practice," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 22(4), pages 1120-1150, August.
    7. Kuhn, Michael & Ochsen, Carsten, 2019. "Population change and the regional distribution of physicians," The Journal of the Economics of Ageing, Elsevier, vol. 14(C).

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    More about this item

    Keywords

    Competition in health care markets; Physician location; Panel econometrics;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L23 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Organization of Production
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models

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