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Addressing the Licensed Doctor Maldistribution in China: A Demand-And-Supply Perspective

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  • Bin Zhu

    (School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
    Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China)

  • Chih-Wei Hsieh

    (Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China)

  • Ying Mao

    (School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China)

Abstract

Background : The maldistribution of licensed doctors is one of the major challenges faced by the Chinese health sector. However, this subject remains underexplored, as the underlying causes of licensed doctor distribution have not been fully mapped out. To fill the research void, this study theoretically modeled and empirically measured various determinants of licensed doctor distribution from both the supply and demand sides while taking the spillover effect between the adjacent geographical units into consideration. Methods : The theory of demand and supply is adopted to construct a research framework so as to explain the imbalance in the licensed doctor distribution. Both direct effects and spillover effects of the supply-side factors and demand-side factors are empirically measured with the spatial panel econometric models. Results : The health service demand was found, as expected, to be the major driving force of the licensed doctor distribution across the nation. That is, the increase in health services demands in a province could significantly help one unit attract licensed doctors from adjacent units. Unexpectedly but intriguingly, the medical education capacity showed a relatively limited effect on increasing the licensed doctor density in local units compared with its spillover effect on neighboring units. In addition, government and social health expenditures played different roles in the health labor market, the former being more effective in increasing the stock of clinicians and public health doctors, the latter doing better in attracting dentists and general practitioners. Conclusions : The results provide directions for Chinese policy makers to formulate more effective policies, including a series of measures to boost the licensed doctor stock in disadvantaged areas, such as the increase of government or social health expenditures, more quotas for medical universities, and the prevention of a brain drain of licensed doctors.

Suggested Citation

  • Bin Zhu & Chih-Wei Hsieh & Ying Mao, 2019. "Addressing the Licensed Doctor Maldistribution in China: A Demand-And-Supply Perspective," IJERPH, MDPI, vol. 16(10), pages 1-19, May.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:10:p:1753-:d:232076
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    References listed on IDEAS

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    1. Hausman, Jerry, 2015. "Specification tests in econometrics," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 38(2), pages 112-134.
    2. Manfred M. Fischer & Arthur Getis (ed.), 2010. "Handbook of Applied Spatial Analysis," Springer Books, Springer, number 978-3-642-03647-7, September.
    3. Barbara McPake & Anthony Scott & Ijeoma Edoka, 2014. "Analyzing Markets for Health Workers : Insights from Labor and Health Economics," World Bank Publications - Books, The World Bank Group, number 18780, December.
    4. Jinlin Liu & Bin Zhu & Ying Mao, 2018. "Association between rural clinical clerkship and medical students’ intentions to choose rural medical work after graduation: A cross-sectional study in western China," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-16, April.
    5. Jianhuan Huang & Jiejin Xia, 2016. "Regional Competition, Heterogeneous Factors and Pollution Intensity in China: A Spatial Econometric Analysis," Sustainability, MDPI, vol. 8(2), pages 1-26, February.
    6. Bin Zhu & Yang Fu & Jinlin Liu & Ying Mao, 2018. "Modeling the Dynamics and Spillovers of the Health Labor Market: Evidence from China’s Provincial Panel Data," Sustainability, MDPI, vol. 10(2), pages 1-20, January.
    7. Lee, Donghoon & Wolpin, Kenneth I., 2010. "Accounting for wage and employment changes in the US from 1968-2000: A dynamic model of labor market equilibrium," Journal of Econometrics, Elsevier, vol. 156(1), pages 68-85, May.
    8. Yan-Qing Kang & Tao Zhao & Peng Wu, 2016. "Impacts of energy-related CO2 emissions in China: a spatial panel data technique," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 81(1), pages 405-421, March.
    9. Yu Liu & Hongwei Xiao & Precious Zikhali & Yingkang Lv, 2014. "Carbon Emissions in China: A Spatial Econometric Analysis at the Regional Level," Sustainability, MDPI, vol. 6(9), pages 1-19, September.
    10. Zhimin Zhou & Xinyue Ye & Xiangyu Ge, 2017. "The Impacts of Technical Progress on Sulfur Dioxide Kuznets Curve in China: A Spatial Panel Data Approach," Sustainability, MDPI, vol. 9(4), pages 1-27, April.
    11. J. Elhorst, 2010. "Applied Spatial Econometrics: Raising the Bar," Spatial Economic Analysis, Taylor & Francis Journals, vol. 5(1), pages 9-28.
    12. Ian McRae & James Butler, 2014. "Supply and demand in physician markets: a panel data analysis of GP services in Australia," International Journal of Health Economics and Management, Springer, vol. 14(3), pages 269-287, September.
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