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

Author

Listed:
  • Sandra Nocera
  • Gabrielle Wanzenried

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.

Suggested Citation

  • Sandra Nocera & Gabrielle Wanzenried, 2002. "On the Dynamics of Physician Density; Theory and Empirical Evidence for Switzerland," Diskussionsschriften dp0208, Universitaet Bern, Departement Volkswirtschaft.
  • Handle: RePEc:ube:dpvwib:dp0208
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    References listed on IDEAS

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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. A. Bhargava & L. Franzini & W. Narendranathan, 2006. "Serial Correlation and the Fixed Effects Model," World Scientific Book Chapters,in: Econometrics, Statistics And Computational Approaches In Food And Health Sciences, chapter 4, pages 61-77 World Scientific Publishing Co. Pte. Ltd..
    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 703-732, October.
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
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    More about this item

    Keywords

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

    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
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models

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