Demographic and geographic determinants of regional physician supply
Against 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.
|Date of creation:||2009|
|Date of revision:|
|Contact details of provider:|| Postal: Ulmenstr. 69, 18057 Rostock|
Web page: http://www.wiwi.uni-rostock.de/en/econ/department-of-economics/
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- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Nuscheler, Robert, 2002.
"Physician reimbursement, time-consistency and the quality of care
[Ärztevergütung, Zeitkonsistenz und die Qualität medizinischer Leistungen]," Discussion Papers, Research Unit: Market Processes and Governance FS IV 02-16, Social Science Research Center Berlin (WZB).
- Nuscheler, Robert, 2002. "Physician reimbursement, time-consistency and the quality of care
- repec:dau:papers:123456789/3881 is not listed on IDEAS
- Gravelle, Hugh, 1999. "Capitation contracts: access and quality," Journal of Health Economics, Elsevier, vol. 18(3), pages 315-340, June.
- 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.
- 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.
- B. Dormont & A.-L. Samson, 2008.
"Medical demography and intergenerational inequalities in general practitioners' earnings,"
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.
- 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.
- 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.
- Brigitte Dormont & Michel Grignon & Hélène Huber, 2006.
"Health expenditure growth: reassessing the threat of ageing,"
John Wiley & Sons, Ltd., vol. 15(9), pages 947-963.
- Brigitte Dormont & Michel Grignon & Hélène Huber, 2006. "Health expenditure growth : reassessing the threat of ageing," Post-Print halshs-00181605, HAL.
- 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.
- 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.
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