Does the Geographical Distribution of Physicians Reflect Market Failure?

Newhouse, Joseph P.; Williams, Albert P.; Bennett, Bruce; Schwartz, William B.

doi:10.2307/3003469

Cited by 120 publications

(93 citation statements)

References 8 publications

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“…They also test a dynamic model and find that areas that had more physicians per capita in 1996 had lower growth in the number of physicians per capita. This is consistent with the results reported in Newhouse et al [7]. Brown [10] also confirms this relationship for the Canadian province of Alberta, although the evidence is not overwhelming.…”

Section: Literature Reviewsupporting

confidence: 83%

“…The relationship between population and market structure (number of suppliers) for the market of physicians was first investigated empirically by Newhouse et al [7], who found that the size of a town affects the probability of a physician being located there. They also make use of the fact that the number of specialists in the U.S. increased dramatically over the decade of the 1970s.…”

Section: Literature Reviewmentioning

confidence: 99%

“…The model can then be estimated using an ordered probit specification for the number of firms in any given market (y) 7 :…”

Section: Empirical Frameworkmentioning

confidence: 99%

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Market structure and competition in the healthcare industry

et al. 2018

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The present paper provides first empirical evidence on the relationship between market size and the number of firms in the healthcare industry for a transition economy. We estimate market-size thresholds required to support different numbers of suppliers (firms) for three occupations in the healthcare industry in a large number of distinct geographic markets in Slovakia, taking into account the spatial interaction between local markets. The empirical analysis is carried out for three time periods (1995, 2001 and 2010) which characterise different stages of the transition process. Our results suggest that the relationship between market size and the number of firms differs both across industries and across periods. In particular, we find that pharmacies, as the only completely liberalised market in our dataset, experience the largest change in competitive behaviour during the transition process. Furthermore, we find evidence for correlation in entry decisions across administrative borders, suggesting that future market analysis should aim to capture these regional effects.

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Section: Literature Reviewsupporting

confidence: 83%

Section: Literature Reviewmentioning

confidence: 99%

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Market structure and competition in the healthcare industry

et al. 2018

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“…4,16 We also posited, based on literature relating to the distribution of other health professionals, that physiotherapists in academic regions could draw patients from nearby cities and CDs, which would create a lower density of therapists in adjacent regions. 17,18 Third, we used an economic model of spatial competition to understand the likely location strategies of physiotherapists if they respond to competitive forces.…”

mentioning

confidence: 99%

The Distribution of Physiotherapists in Ontario: Understanding the Market Drivers

Holyoke

Verrier²,

Landry

et al. 2012

Physiotherapy Canada

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Purpose: To understand the factors that affect the distribution of physiotherapists in Ontario by examining three potential influences in the multi-payer physiotherapy (PT) market: population need, critical mass (related to academic health science centres [AHSCs]), and market forces. Methods: Physiotherapist density and distribution were calculated from 2003 and 2005 College of Physiotherapists of Ontario registration data. Physiotherapists' workplaces were classified as not-for-profit (NFP) hospitals, other NFP, or for-profit (FP), and their locations were classified by census division (CD) types (cities and counties). Results: Physiotherapist density varied significantly and distribution was neither uniformly responsive to population need, nor driven primarily by market forces. The largest factor was an AHSC in a CD; physiotherapists locate disproportionately in NFP hospitals in AHSCs rather than in the growing FP sector. Conclusions: While some patterns can be discerned in the distribution and densities of physiotherapists across Ontario, further work needs to be done to identify why population need and market forces appear to be less influential, and why CDs with AHSCs are so attractive to physiotherapists. With this additional information, it may be possible to identify ways to influence uneven distribution in the future.Key Words: delivery of health care market; health manpower; policy; demography. RÉ SUMÉObjectif : Comprendre les facteurs qui affectent la ré partition des physiothé rapeutes en Ontario en analysant trois influences potentielles dans le marché de la physiothé rapie à payeurs multiples, soit les besoins de la population, la masse critique (lié e aux centres universitaires de sciences de la santé ) et les forces du marché . Mé thode : La ré partition et la densité de physiothé rapeutes ont é té calculé es pour les anné es 2003 et 2005 à partir des donné es d'inscription à l'Ordre des physiothé rapeutes de l'Ontario. Les milieux de travail des physiothé rapeutes ont é té classé s par caté gories : hô pitaux à but non lucratif (HBNL) ou autres milieux à but non lucratif (BNL) ou à but lucratif (BL). Leurs emplacements ont ensuite é té classé s par types de division du recensement (villes ou comté s). Ré sultats : La densité de physiothé rapeutes varie considé rablement et leur ré partition n'é tait ni unilaté ralement dé finie en fonction des besoins de la population, ni motivé e principalement par les forces du marché . Le plus important facteur é tait un centre universitaire de sciences de la santé dans une division du recensement; les physiothé rapeutes sont pré sents de maniè re disproportionné e dans les hô pitaux à but non lucratif de tels centres universitaires au lieu d'ê tre dans le secteur en croissance des cliniques à but lucratif. Conclusions : Bien que certains modè les peuvent ê tre dé gagé s dans la ré partition et la densité des physiothé rapeutes en Ontario, d'autres recherches devront ê tre entreprises afin de pré ciser pourquoi les besoins de la population et les forc...

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“…The necessity of these programs has been questioned by some who suggest that economic forces will adequately distribute physicians as their services are demanded, because market forces are functioning, especially with regard to the urban-rural distribution of physicians. 3 The administration and Congress have chosen to partially accept this argument and have reduced federal efforts to influence the specialty and diversity distribution of physicians in the Title VII programs that support training of primary care practitioners, promote diversity, and emphasize subsequent practice in underserved communities. In contrast, the National Health Service Corps (NHSC) continues to receive support and appropriations to address problems with the geographic distribution of primary care physicians.…”

mentioning

confidence: 99%

The Diffusion Of Physicians

Ricketts

Randolph

2008

Health Affairs

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Physicians move from place to place over their careers; this is thought to reflect the economic theory that they seek better opportunities to practice. Using national data, this study tracked physician movement between counties classified by physician-topopulation ratio and socioeconomic characteristics. Approximately one-quarter of practicing physicians moved in each of two ten-year periods, 1981-1991 and 1991-2001. The overall tendency of movers was to go to places with lower physician-to-population ratios but higher per capita incomes and lower unemployment. These trends, if they continue, may help decrease access to physician care in rural and urban underserved areas.

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Does the Geographical Distribution of Physicians Reflect Market Failure?

Cited by 120 publications

References 8 publications

Market structure and competition in the healthcare industry

Market structure and competition in the healthcare industry

The Distribution of Physiotherapists in Ontario: Understanding the Market Drivers

The Diffusion Of Physicians

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