IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v11y2010i4p383-393.html
   My bibliography  Save this article

Geographic distribution of physicians in Portugal

Author

Listed:
  • Correia Isabel
  • Veiga Paula

Abstract

The main goals of this paper are to (1) analyse the inequality in geographic distribution of physicians and its evolution, (2) estimate the determinants of physician density, and (3) assess the importance of competitive and agglomerative forces in location decisions. The analysis of the geographic distribution of physicians is based on the ratio of general practitioners (GPs) and specialists to 1,000 inhabitants. The inequality is measured using Gini indices, coefficients of variation, and physician-to-population ratios. The econometric models were estimated by ordinary least squares. The data used refer to 1996 and 2007. The impact of the growing number of physicians, and therefore potential increased competition, on geographic distribution during the period studied was small. Nonetheless, there is evidence of competitive forces acting on the dynamics of doctor localisation. Geographic disparities in physician density are still high, and appear to be due mainly to geographic income inequality.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Correia Isabel & Veiga Paula, 2010. "Geographic distribution of physicians in Portugal," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(4), pages 383-393, August.
  • Handle: RePEc:spr:eujhec:v:11:y:2010:i:4:p:383-393
    DOI: 10.1007/s10198-009-0208-8
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1007/s10198-009-0208-8
    Download Restriction: Access to full text is restricted to subscribers.

    File URL: https://libkey.io/10.1007/s10198-009-0208-8?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. 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.
    2. Kuhn, Michael & Ochsen, Carsten, 2009. "Demographic and geographic determinants of regional physician supply," Thuenen-Series of Applied Economic Theory 105, University of Rostock, Institute of Economics.
    3. 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.
    4. Robert G. Evans, 1974. "Supplier-Induced Demand: Some Empirical Evidence and Implications," International Economic Association Series, in: Mark Perlman (ed.), The Economics of Health and Medical Care, chapter 10, pages 162-173, Palgrave Macmillan.
    5. Chomitz, Kenneth M. & Setiadi, Gunawan & Azwar, Azrul & Ismail, Nusye & Widiyarti, 1998. "What do doctors want? developing incentives for doctors to serve in Indonesia's rural and remote areas," Policy Research Working Paper Series 1888, The World Bank.
    6. Kristiansen, Ivar Sønbø & Førde, Olav Helge, 1992. "Medical specialists' choice of location: The role of geographical attachment in Norway," Social Science & Medicine, Elsevier, vol. 34(1), pages 57-62, January.
    7. Horev, Tuvia & Pesis-Katz, Irena & Mukamel, Dana B., 2004. "Trends in geographic disparities in allocation of health care resources in the US," Health Policy, Elsevier, vol. 68(2), pages 223-232, May.
    8. Carlsen, Fredrik & Grytten, Jostein, 2000. "Consumer satisfaction and supplier induced demand," Journal of Health Economics, Elsevier, vol. 19(5), pages 731-753, September.
    9. T Rice & R Labelle, 1989. "Do Physicians Induce Demand for Medical Service?," Centre for Health Economics and Policy Analysis Working Paper Series 18, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    10. Boris Kralj, 2001. "Physician Distribution and Physician Shortage Intensity in Ontario," Canadian Public Policy, University of Toronto Press, vol. 27(2), pages 167-178, June.
    11. 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 703-732, October.
    12. Steven Simoens & Jeremy Hurst, 2006. "The Supply of Physician Services in OECD Countries," OECD Health Working Papers 21, OECD Publishing.
    13. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income‐related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647, July.
    14. Anna Dixon & Elias Mossialos, 2000. "Has the Portuguese NHS Achieved its Objectives of Equity and Efficiency?," International Social Security Review, John Wiley & Sons, vol. 53(4), pages 49-78, November.
    15. Pyatt, Graham, 1976. "On the Interpretation and Disaggregation of Gini Coefficients," Economic Journal, Royal Economic Society, vol. 86(342), pages 243-255, June.
    16. Gabrielle Wanzenried & Sandra Nocera, 2008. "The Evolution of Physician Density in Switzerland," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 144(II), pages 247-282, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Justyna Rój, 2020. "Inequality in the Distribution of Healthcare Human Resources in Poland," Sustainability, MDPI, vol. 12(5), pages 1-27, March.
    2. Julien Silhol & Bruno Ventelou & Anna Zaytseva, 2020. "How French general practitioners respond to declining medical density: a study on prescription practices, with an insight into opioids use," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1391-1398, December.
    3. Qin, Xuezheng & Hsieh, Chee-Ruey, 2014. "Economic growth and the geographic maldistribution of health care resources: Evidence from China, 1949-2010," China Economic Review, Elsevier, vol. 31(C), pages 228-246.
    4. Herwartz, Helmut & Schley, Katharina, 2018. "Improving health care service provision by adapting to regional diversity: An efficiency analysis for the case of Germany," Health Policy, Elsevier, vol. 122(3), pages 293-300.
    5. Martin Lábaj & Alzbeta Siskovicova & Barbora Skalicanova & Peter Silanic & Christoph Weiss & Biliana Yontcheva, 2015. "Market Structure and Competition in the Health-care Industry: Results from a Transition Economy," Department of Economic Policy Working Paper Series 010, Department of Economic Policy, Faculty of National Economy, University of Economics in Bratislava.
    6. Pedro Ramos & Hélio Alves & Paulo Guimarães & Maria A. Ferreira, 2017. "Junior doctors’ medical specialty and practice location choice: simulating policies to overcome regional inequalities," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(8), pages 1013-1030, November.
    7. Vogt, Verena, 2016. "The contribution of locational factors to regional variations in office-based physicians in Germany," Health Policy, Elsevier, vol. 120(2), pages 198-204.
    8. Terance J. Rephann & Tanya Wanchek, 2012. "Filling the Gaps: Dentist Disparities along the Rural Urban Continuum," Working Papers 2012-02, Center for Economic and Policy Studies.
    9. Gaynor, Martin & Town, Robert J., 2011. "Competition in Health Care Markets," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 499-637, Elsevier.
    10. Katharina Schley, 2018. "Health care service provision in Europe and regional diversity: a stochastic metafrontier approach," Health Economics Review, Springer, vol. 8(1), pages 1-11, December.
    11. Rephann, Terance J. & Wanchek, Tanya N., 2016. "Filling the Gaps: Explanations for Disparities in the Distribution of Dentists among U.S. Counties," Journal of Regional Analysis and Policy, Mid-Continent Regional Science Association, vol. 46(1).
    12. Rouven Edgar Haschka & Katharina Schley & Helmut Herwartz, 2020. "Provision of health care services and regional diversity in Germany: insights from a Bayesian health frontier analysis with spatial dependencies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 55-71, February.
    13. 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.
    14. Martin Lábaj & Peter Silanič & Christoph Weiss & Biliana Yontcheva, 2018. "Market structure and competition in the healthcare industry," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(8), pages 1087-1110, November.
    15. Abu-Qarn, Aamer & Lichtman-Sadot, Shirlee, 2021. "Older Adult Health Following Greater Access to Secondary Health Care: Evidence from Bus Service Introductions to Arab Towns in Israel," IZA Discussion Papers 14490, Institute of Labor Economics (IZA).
    16. Xiaolin Cao & Ge Bai & Chunxiang Cao & Yinan Zhou & Xuechen Xiong & Jiaoling Huang & Li Luo, 2020. "Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017," IJERPH, MDPI, vol. 17(5), pages 1-13, February.
    17. Pierre Polzin & José Borges & António Coelho, 2014. "An Extended Kernel Density Two-Step Floating Catchment Area Method to Analyze Access to Health Care," Environment and Planning B, , vol. 41(4), pages 717-735, August.
    18. Stéphanie Truchet & Nicolas Mauhe & Marie Herve, 2017. "Veterinarian shortage areas: what determines the location of new graduates?," Review of Agricultural, Food and Environmental Studies, Springer, vol. 98(4), pages 255-282, December.
    19. Kuhn, Michael & Ochsen, Carsten, 2019. "Population change and the regional distribution of physicians," The Journal of the Economics of Ageing, Elsevier, vol. 14(C).
    20. Ramos, Pedro & Alves, Hélio, 2017. "Migration intentions among Portuguese junior doctors: Results from a survey," Health Policy, Elsevier, vol. 121(12), pages 1208-1214.
    21. Abu-Qarn, Aamer & Lichtman-Sadot, Shirlee, 2022. "Can greater access to secondary health care decrease health inequality? Evidence from bus line introduction to Arab towns in Israel," Economic Modelling, Elsevier, vol. 106(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Sandra Nocera & Gabrielle Wanzenried, 2002. "On the Dynamics of Physician Density; Theory and Empirical Evidence for Switzerland," Diskussionsschriften dp0208, Universitaet Bern, Departement Volkswirtschaft.
    2. Serneels, Pieter & Lindelow, Magnus & Garcia-Montalvo, Jose & Barr, Abigail, 2005. "For public service or money : understanding geographical imbalances in the health workforce," Policy Research Working Paper Series 3686, The World Bank.
    3. Mu, Chunzhou, 2015. "The age profile of the location decision of Australian general practitioners," Social Science & Medicine, Elsevier, vol. 142(C), pages 183-193.
    4. Pieter Serneels & Magnus Lindelow & José Garcia Montalvo & Abigail Barr, 2006. "For public service or money: Understanding geographical imbalances in the health workforce in Ethiopia," Economics Working Papers 989, Department of Economics and Business, Universitat Pompeu Fabra.
    5. Eric Delattre & Anne-Laure Samson, 2012. "Stratégies de localisation des médecins généralistes français : mécanismes économiques ou hédonistes ?," Économie et Statistique, Programme National Persée, vol. 455(1), pages 115-142.
    6. Bernard Fortin & Nicolas Jacquemet & Bruce Shearer, 2008. "Policy Analysis in Health-Services Market: Accounting for Quality and Quantity," Annals of Economics and Statistics, GENES, issue 91-92, pages 293-319.
    7. 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.
    8. repec:dau:papers:123456789/11295 is not listed on IDEAS
    9. Pieter Serneels & Abigail Barr & Magnus Lindelow, 2005. "Understanding Geographical Imbalances in the Health Workforce," Economics Series Working Papers GPRG-WPS-018, University of Oxford, Department of Economics.
    10. 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.
    11. Gabrielle Wanzenried & Sandra Nocera, 2008. "The Evolution of Physician Density in Switzerland," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 144(II), pages 247-282, June.
    12. Martin Gaynor, 1994. "Issues in the Industrial Organization of the Market for Physician Services," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 211-255, March.
    13. Yip, Winnie C., 1998. "Physician response to Medicare fee reductions: changes in the volume of coronary artery bypass graft (CABG) surgeries in the Medicare and private sectors," Journal of Health Economics, Elsevier, vol. 17(6), pages 675-699, December.
    14. Chen, Zhuo & Roy, Kakoli & Haddix, Anne C. & Thacker, Stephen B., 2010. "Factors associated with differences in mortality and self-reported health across states in the United States," Health Policy, Elsevier, vol. 94(3), pages 203-210, March.
    15. Philippe Batifoulier & Nicolas Da Silva, 2014. "The economic behaviour of doctors: medical altruism without an ethic?," EconomiX Working Papers 2014-9, University of Paris Nanterre, EconomiX.
    16. Mónica Duarte Oliveira & Carlos Gouveia Pinto, 2005. "Health care reform in Portugal: an evaluation of the NHS experience," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 203-220, September.
    17. Julie Riise Kolstad, 2011. "How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 196-211, February.
    18. George M. Holmes, 2004. "Does the National Health Service Corps Improve Physician Supply in Underserved Locations?," Eastern Economic Journal, Eastern Economic Association, vol. 30(4), pages 563-581, Fall.
    19. Liping Fu & Kaibo Xu & Feng Liu & Lu Liang & Zhengmin Wang, 2021. "Regional Disparity and Patients Mobility: Benefits and Spillover Effects of the Spatial Network Structure of the Health Services in China," IJERPH, MDPI, vol. 18(3), pages 1-16, January.
    20. Denis Bolduc & Bernard Fortin & Stephen Gordon, 1997. "Multinomial Probit Estimation of Spatially Interdependent Choices: An Empirical Comparison of Two New Techniques," International Regional Science Review, , vol. 20(1-2), pages 77-101, April.
    21. Iversen, Tor & Luras, Hilde, 2000. "Economic motives and professional norms: the case of general medical practice," Journal of Economic Behavior & Organization, Elsevier, vol. 43(4), pages 447-470, December.

    More about this item

    Keywords

    Physicians; Location choice; Geographic inequality; Health resources; Portugal; I10; I11;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:11:y:2010:i:4:p:383-393. See general information about how to correct material in RePEc.

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.