Historically, US policy regarding distribution of physicians has been simply to influence the total supply of physicians, believing that economic dynamics would lead to an equitable distribution throughout the nation. To the extent that new doctors are not moving to rural areas, there could still be "shortages" in access to care.
This project analyzed determinants of physician location choice. Using cross-sectional data of 139 California Healthcare Facility Planning Areas, I study demand shift, supply shift, and local amenity variables and their long-run effect on number of physicians per 100,000 population in each market.
I used physician location data from the California Medical Association, patient discharge data from California's Office of Statewide Healthcare Planning and Development, and demographic data from the US Census Bureau. I found that average incomes, availability of hospital resources, and population density (folks per square mile) have positive effects on physician density. The prevalence of managed care insurance, existence of only one hospital, and high proportions of people under age 18 and over 63 years have negative effects on physician density.
Rural areas in California appear to be rich in most of the economic characteristics that lead to lower physician densities. They tend to have smaller average incomes, higher proportions of elderly folks, more difficult access to hospital facilities, more concentrated hospital markets, and fewer local leisure amenities than metropolitan areas. Consequently, they also have smaller physician densities. It is not clear that we will solve the distribution problem by merely graduating a larger number of new MDs.
Learning Objectives: Describe determinants of physician location choice
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.