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The contribution of locational factors to regional variations in office-based physicians in Germany

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  • Vogt, Verena

Abstract

There is considerable literature showing that regional variation in the number of office-based physicians is rather explained by factors such as financial attractiveness of a region or employment opportunities for spouses than by health care needs of the population. It remains unclear, however, how much of the variation is explained by each of these determinants. The aim of the present study is to estimate the percentage contribution of a variety of determinants to the measured variation in Germany. Physician density is regressed on a well-defined set of explanatory variables that were identified as determinants of physician location. Regression-based decomposition was applied to decompose the variation in physician density into the percentage contribution of each of the determinants. The results show that varying health care needs of the population explained less than 5.2% of the variation in physician density. Percentage of population with private health insurance explained 14% of the variation in GP density and between 2% and 6% of the variation in specialists’ density. For specialists, a higher share of variance was attributable to the variables measuring sociocultural amenities of a region compared to GPs.

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  • 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.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:2:p:198-204
    DOI: 10.1016/j.healthpol.2016.01.006
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    References listed on IDEAS

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    1. 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.
    2. Ozegowski, Susanne & Sundmacher, Leonie, 2012. "Ensuring access to health care—Germany reforms supply structures to tackle inequalities," Health Policy, Elsevier, vol. 106(2), pages 105-109.
    3. 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.
    4. Hendrik Jürges & Vincent Pohl, 2012. "Medical guidelines, physician density, and quality of care: evidence from German SHARE data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(5), pages 635-649, October.
    5. Jeremy Hurst & Melissa Jee-Hughes, 2001. "Performance Measurement and Performance Management in OECD Health Systems," OECD Labour Market and Social Policy Occasional Papers 47, OECD Publishing.
    6. Shorrocks, A F, 1982. "Inequality Decomposition by Factor Components," Econometrica, Econometric Society, vol. 50(1), pages 193-211, January.
    7. 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.
    8. Busch, Lawrence & Dale, Christopher, 1978. "The changing distribution of physicians," Socio-Economic Planning Sciences, Elsevier, vol. 12(4), pages 167-176.
    9. 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.
    10. Rochaix, Lise, 1989. "Information asymmetry and search in the market for physicians' services," Journal of Health Economics, Elsevier, vol. 8(1), pages 53-84, March.
    11. Isabel Correia & Paula Veiga, 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.
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    Cited by:

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    2. Danny Wende, 2019. "Spatial risk adjustment between health insurances: using GWR in risk adjustment models to conserve incentives for service optimisation and reduce MAUP," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(7), pages 1079-1091, September.
    3. Sriubaite, Ieva, 2021. "Who will be the mediator? Local politics and hospital closures in Germany," Ruhr Economic Papers 897, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    4. Loup Beduchaud & Enoa Celingant & Clara Faure & Mathilda Meunier & Iñaki Blanco-Cazeaux, 2024. "Do international medical graduates' recruitment policies help to overcome healthcare shortage areas in developed countries? A systematic review," Post-Print hal-04756497, HAL.
    5. Kuhn, Michael & Ochsen, Carsten, 2019. "Population change and the regional distribution of physicians," The Journal of the Economics of Ageing, Elsevier, vol. 14(C).
    6. Wende, Danny & Kopetsch, Thomas & Richter, Wolfram F., 2020. "Planning health care capacities with a gravity equation," Ruhr Economic Papers 888, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.

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