IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v111y2013i1p43-51.html
   My bibliography  Save this article

An empirical analysis of public and private medical practice in Australia

Author

Listed:
  • Cheng, Terence C.
  • Joyce, Catherine M.
  • Scott, Anthony

Abstract

The combination of public and private medical practice is widespread in many health systems and has important consequences for health care cost and quality. However, its forms and prevalence vary widely and are poorly understood. This paper examines factors associated with public and private sector work by medical specialists using a nationally representative sample of Australian doctors. We find considerable variations in the practice patterns, remuneration contracts and professional arrangements across doctors in different work sectors. Both specialists in mixed practice and private practice differ from public sector specialists with regard to their annual earnings, sources of income, maternity and other leave taken and number of practice locations. Public sector specialists are likely to be younger, to be international medical graduates, devote a higher percentage of time to education and research, and are more likely to do after hours and on-call work compared with private sector specialists. Gender and total hours worked do not differ between doctors across the different practice types.

Suggested Citation

  • Cheng, Terence C. & Joyce, Catherine M. & Scott, Anthony, 2013. "An empirical analysis of public and private medical practice in Australia," Health Policy, Elsevier, vol. 111(1), pages 43-51.
    • Handle: RePEc:eee:hepoli:v:111:y:2013:i:1:p:43-51
    DOI: 10.1016/j.healthpol.2013.03.011
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851013000766
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2013.03.011?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Li, Shiyu & Lin, Shuanglin, 2011. "Is there any gain from social security privatization?," China Economic Review, Elsevier, vol. 22(3), pages 278-289, September.
    2. Humphrey, Charlotte & Russell, Jill, 2004. "Motivation and values of hospital consultants in south-east England who work in the national health service and do private practice," Social Science & Medicine, Elsevier, vol. 59(6), pages 1241-1250, September.
    3. Kankaanranta, Terhi & Nummi, Tapio & Vainiomaki, Jari & Halila, Hannu & Hyppola, Harri & Isokoski, Mauri & Kujala, Santero & Kumpusalo, Esko & Mattila, Kari & Virjo, Irma & Vanska, Jukka & Rissanen, P, 2007. "The role of job satisfaction, job dissatisfaction and demographic factors on physicians' intentions to switch work sector from public to private," Health Policy, Elsevier, vol. 83(1), pages 50-64, September.
    4. Garcia-Prado, Ariadna & Gonzalez, Paula, 2007. "Policy and regulatory responses to dual practice in the health sector," Health Policy, Elsevier, vol. 84(2-3), pages 142-152, December.
    5. Productivity Commission, 2009. "Public and Private Hospitals," Research Reports, Productivity Commission, Government of Australia, number 37, July.
    6. Miriam M. Wiley, 2005. "The Irish health system: developments in strategy, structure, funding and delivery since 1980," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 169-186, September.
    7. Anderson, Stuart, 2012. "Public, private, neither, both? Publicness theory and the analysis of healthcare organisations," Social Science & Medicine, Elsevier, vol. 74(3), pages 313-322.
    8. Scott, Anthony, 2001. "Eliciting GPs' preferences for pecuniary and non-pecuniary job characteristics," Journal of Health Economics, Elsevier, vol. 20(3), pages 329-347, May.
    9. Gruen, Reinhold & Anwar, Raqibul & Begum, Tahmina & Killingsworth, James R. & Normand, Charles, 2002. "Dual job holding practitioners in Bangladesh: an exploration," Social Science & Medicine, Elsevier, vol. 54(2), pages 267-279, January.
    10. James Thornton & Fred Esposto, 2003. "How important are economic factors in choice of medical specialty?," Health Economics, John Wiley & Sons, Ltd., vol. 12(1), pages 67-73, January.
    11. Ariadna García-Prado & Paula González, 2006. "Who do physicians work for?," Working Papers 06.28, Universidad Pablo de Olavide, Department of Economics.
    12. Socha, Karolina Z. & Bech, Mickael, 2011. "Physician dual practice: A review of literature," Health Policy, Elsevier, vol. 102(1), pages 1-7, September.
    13. Brown, Laurie & Barnett, J. Ross, 2004. "Is the corporate transformation of hospitals creating a new hybrid health care space? A case study of the impact of co-location of public and private hospitals in Australia," Social Science & Medicine, Elsevier, vol. 58(2), pages 427-444, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Susan J. Méndez & Jongsay Yong & Hugh Gravelle & Anthony Scott, 2024. "Medical pricing decisions: Evidence from Australian specialists," Melbourne Institute Working Paper Series wp2024n11, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    2. Song, Jia & Cheng, Terence C., 2020. "How do gender differences in family responsibilities affect doctors' labour supply? Evidence from Australian panel data," Social Science & Medicine, Elsevier, vol. 265(C).
    3. Terence C. Cheng & Guyonne Kalb & Anthony Scott, 2018. "Public, private or both? Analyzing factors influencing the labour supply of medical specialists," Canadian Journal of Economics, Canadian Economics Association, vol. 51(2), pages 660-692, May.
    4. Ou Yang & Jongsay Yong & Yuting Zhang, 2024. "Effects of private health insurance on waiting time in public hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 33(6), pages 1192-1210, June.
    5. Cheng, Terence C. & Haisken-DeNew, John P. & Yong, Jongsay, 2015. "Cream skimming and hospital transfers in a mixed public-private system," Social Science & Medicine, Elsevier, vol. 132(C), pages 156-164.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. González, Paula & Macho-Stadler, Inés, 2013. "A theoretical approach to dual practice regulations in the health sector," Journal of Health Economics, Elsevier, vol. 32(1), pages 66-87.
    2. Socha, Karolina Z. & Bech, Mickael, 2011. "Physician dual practice: A review of literature," Health Policy, Elsevier, vol. 102(1), pages 1-7, September.
    3. Terence C. Cheng & Guyonne Kalb & Anthony Scott, 2018. "Public, private or both? Analyzing factors influencing the labour supply of medical specialists," Canadian Journal of Economics, Canadian Economics Association, vol. 51(2), pages 660-692, May.
    4. Gacevic, Marijana & Santric Milicevic, Milena & Vasic, Milena & Horozovic, Vesna & Milicevic, Marko & Milic, Natasa, 2018. "The relationship between dual practice, intention to work abroad and job satisfaction: A population-based study in the Serbian public healthcare sector," Health Policy, Elsevier, vol. 122(10), pages 1132-1139.
    5. Michael Kuhn & Robert Nuscheler, 2020. "Saving the public from the private? Incentives and outcomes in dual practice," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 22(4), pages 1120-1150, August.
    6. Barış Alpaslan & King Yoong Lim & Yan Song, 2021. "Growth and welfare in mixed health system financing with physician dual practice in a developing economy: a case of Indonesia," International Journal of Health Economics and Management, Springer, vol. 21(1), pages 51-80, March.
    7. Garcia-Prado, Ariadna & Gonzalez, Paula, 2007. "Policy and regulatory responses to dual practice in the health sector," Health Policy, Elsevier, vol. 84(2-3), pages 142-152, December.
    8. Pestana, Joana & Frutuoso, João & Costa, Eduardo & Fonseca, Filipa, 2024. "Heterogeneity in physician's job preferences in a dual practice context – Evidence from a DCE," Social Science & Medicine, Elsevier, vol. 343(C).
    9. Dr. Sukhan Jackson & Kamalakanthan, Abhayaprada, 2006. "The Supply of Doctors in Australia: Is There A Shortage?," Discussion Papers Series 341, School of Economics, University of Queensland, Australia.
    10. Pei-Jyun Lu & Jui-Yao Liu & Hsin Ma & Tzeng-Ji Chen & Li-Fang Chou & Shinn-Jang Hwang, 2022. "Characteristics of Clinics without National Health Insurance Contracts: A Nationwide Survey in Taiwan," IJERPH, MDPI, vol. 19(3), pages 1-10, January.
    11. Sivey, Peter & Scott, Anthony & Witt, Julia & Joyce, Catherine & Humphreys, John, 2012. "Junior doctors’ preferences for specialty choice," Journal of Health Economics, Elsevier, vol. 31(6), pages 813-823.
    12. Pedro Ramos & Hélio Alves & Paulo Guimarães & Maria A. Ferreira, 2017. "Junior doctors’ medical specialty and practice location choice: simulating policies to overcome regional inequalities," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(8), pages 1013-1030, November.
    13. Mohsen Bayati & Arash Rashidian & Hamed Zandian & Somayeh Alipoori, 2020. "Dual practice and multiple job holding among Iranian general practitioners: Rate and effective factors," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(3), pages 799-807, May.
    14. Socha, Karolina, 2010. "Physician dual practice and the public health care provision. Review of the literature," DaCHE discussion papers 2010:4, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    15. Kankaanranta, Terhi & Nummi, Tapio & Vainiomaki, Jari & Halila, Hannu & Hyppola, Harri & Isokoski, Mauri & Kujala, Santero & Kumpusalo, Esko & Mattila, Kari & Virjo, Irma & Vanska, Jukka & Rissanen, P, 2007. "The role of job satisfaction, job dissatisfaction and demographic factors on physicians' intentions to switch work sector from public to private," Health Policy, Elsevier, vol. 83(1), pages 50-64, September.
    16. Maria K. Humlum & Kristin J. Kleinjans & Helena S. Nielsen, 2012. "An Economic Analysis Of Identity And Career Choice," Economic Inquiry, Western Economic Association International, vol. 50(1), pages 39-61, January.
    17. Zhichao Wang & Valentin Zelenyuk, 2021. "Performance Analysis of Hospitals in Australia and its Peers: A Systematic Review," CEPA Working Papers Series WP012021, School of Economics, University of Queensland, Australia.
    18. Kok, Lucy & Boyle, Seán & Lammers, Marloes & Tempelman, Caren, 2015. "Remuneration of medical specialists. Drivers of the differences between six European countries," Health Policy, Elsevier, vol. 119(9), pages 1188-1196.
    19. Indranil Dutta & Mario Pezzino & Yan Song, 2022. "Should developing countries ban dual practice by physicians? Analysis under mixed hospital competition," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2289-2310, November.
    20. Lancsar, Emily & Louviere, Jordan & Flynn, Terry, 2007. "Several methods to investigate relative attribute impact in stated preference experiments," Social Science & Medicine, Elsevier, vol. 64(8), pages 1738-1753, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:111:y:2013:i:1:p:43-51. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.