Geographic Distribution of Physicians in Portugal

Overview

Journal Eur J Health Econ

Specialty Health Services

Date 2009 Dec 17

PMID 20012127

Citations 30

Authors

Correia Isabel

Veiga Paula

Affiliations

Soon will be listed here.

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.

Citing Articles

Primary health care coverage in Portugal: the promise of a general practitioner for all.

Costa E, Pestana J, Pita Barros P Hum Resour Health. 2024; 22(1):55.

PMID: 39123226 PMC: 11316367. DOI: 10.1186/s12960-024-00936-7.

Medical residency in Portugal: a cross-sectional study on the working conditions.

Chen-Xu J, Miranda Castilho B, Moura Fernandes B, Silva Goncalves D, Ferreira A, Goncalves A Front Health Serv. 2023; 3():1190357.

PMID: 38116534 PMC: 10728646. DOI: 10.3389/frhs.2023.1190357.

Gender difference of geographic distribution of physicians in Japan: three-point analysis of 1994, 2004 and 2014.

Kimura K, Inoue K, Ando T, Ito M BMC Health Serv Res. 2023; 23(1):1404.

PMID: 38093353 PMC: 10720184. DOI: 10.1186/s12913-023-10258-4.

Effect of doctor allocation policies on the equitable distribution of doctors in Thailand.

Noree T, Pagaiya N, Nimnual I Hum Resour Health. 2023; 21(1):1.

PMID: 36639659 PMC: 9838019. DOI: 10.1186/s12960-022-00782-5.

Finding flaws in the spatial distribution of health workforce and its influential factors: An empirical analysis based on Chinese provincial panel data, 2010-2019.

Bai Q, Ke X, Huang L, Liu L, Xue D, Bian Y Front Public Health. 2023; 10:953695.

PMID: 36589992 PMC: 9794860. DOI: 10.3389/fpubh.2022.953695.

References

Brown M . Do physicians locate as spatial competition models predict? Evidence from Alberta. CMAJ. 1993; 148(8):1301-7. PMC: 1491723. View

Watson C . The relationship between physician practice location and medical school area: an empirical model. Soc Sci Med (1967). 1980; 14D(1):63-9. DOI: 10.1016/0160-8002(80)90033-7. View

Rosenthal M, Zaslavsky A, Newhouse J . The geographic distribution of physicians revisited. Health Serv Res. 2005; 40(6 Pt 1):1931-52. PMC: 1361233. DOI: 10.1111/j.1475-6773.2005.00440.x. View

Rice T, Labelle R . Do physicians induce demand for medical services?. J Health Polit Policy Law. 1989; 14(3):587-600. DOI: 10.1215/03616878-14-3-587. View

Kristiansen I, Forde O . Medical specialists' choice of location: the role of geographical attachment in Norway. Soc Sci Med. 1992; 34(1):57-62. DOI: 10.1016/0277-9536(92)90067-z. View

Brown M . Using Gini-style indices to evaluate the spatial patterns of health practitioners: theoretical considerations and an application based on Alberta data. Soc Sci Med. 1994; 38(9):1243-56. DOI: 10.1016/0277-9536(94)90189-9. View

Burfield W, Hough D, Marder W . Location of medical education and choice of location of practice. J Med Educ. 1986; 61(7):545-54. DOI: 10.1097/00001888-198607000-00001. View

Carlsen F, Grytten J . Consumer satisfaction and supplier induced demand. J Health Econ. 2001; 19(5):731-53. DOI: 10.1016/s0167-6296(00)00044-8. View

NEWHOUSE J, Williams A, Bennett B, SCHWARTZ W . Where have all the doctors gone?. JAMA. 1982; 247(17):2392-6. View

10.

Hurley J . Simulated effects of incomes-based policies on the distribution of physicians. Med Care. 1990; 28(3):221-38. DOI: 10.1097/00005650-199003000-00003. View

11.

Hann M, Gravelle H . The maldistribution of general practitioners in England and Wales: 1974-2003. Br J Gen Pract. 2004; 54(509):894-8. PMC: 1326105. View

12.

van Doorslaer E, Koolman X, Jones A . Explaining income-related inequalities in doctor utilisation in Europe. Health Econ. 2004; 13(7):629-47. DOI: 10.1002/hec.919. View

13.

Gravelle H, Sutton M . Inequality in the geographical distribution of general practitioners in England and Wales 1974-1995. J Health Serv Res Policy. 2001; 6(1):6-13. DOI: 10.1258/1355819011927143. View

14.

Munga M, Maestad O . Measuring inequalities in the distribution of health workers: the case of Tanzania. Hum Resour Health. 2009; 7:4. PMC: 2655278. DOI: 10.1186/1478-4491-7-4. View

15.

SCHWARTZ W, NEWHOUSE J, Bennett B, Williams A . The changing geographic distribution of board-certified physicians. N Engl J Med. 1980; 303(18):1032-8. DOI: 10.1056/NEJM198010303031803. View

16.

Povoa L, Andrade M . [Geographic distribution of physicians in Brazil: an analysis based on a locational choice model]. Cad Saude Publica. 2006; 22(8):1555-64. DOI: 10.1590/s0102-311x2006000800004. View

17.

Horev T, Pesis-Katz I, Mukamel D . Trends in geographic disparities in allocation of health care resources in the US. Health Policy. 2004; 68(2):223-32. DOI: 10.1016/j.healthpol.2003.09.011. View