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Demographic and geographic determinants of regional physician supply

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  • Kuhn, Michael
  • Ochsen, Carsten

Abstract

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.

Suggested Citation

  • 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.
  • Handle: RePEc:zbw:roswps:105
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    References listed on IDEAS

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    Cited by:

    1. Gunther Tichy, 2015. "Protecting social inclusion and mobility in a low growth scenario," WWWforEurope Working Papers series 100, WWWforEurope.
    2. 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.
    3. 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.
    4. Britta Stoever, 2016. "Modelling the ambulant health-care sector in Germany," EcoMod2016 9214, EcoMod.

    More about this item

    Keywords

    age structure; physician supply; regional population ageing; regional migration; overlapping generations; panel data; spatial model;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • J10 - Labor and Demographic Economics - - Demographic Economics - - - General
    • R23 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Regional Migration; Regional Labor Markets; Population
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models

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