The geographic distribution of providers is an important issue in planned and market-oriented health care systems. Planned systems must balance access against costs to establish an "ideal" distribution of providers. Market-oriented systems permit greater mobility, but concerns arise about local imbalances and their effects on public health. In both systems, health workforce reductions magnify concerns about provider shortages, access to care, and public health. One sector already experiencing such reductions is the U.S. dental sector.
This paper develops a model that: (1) incorporates the economic behavior of dentists and patients; (2) determines local dental care prices and utilization patterns; and (3) distributes dentists across a system of local markets. Analysis of the model yields hypotheses regarding factors that affect the distribution of dentists: population and geographic size of the local area, dental input prices, characteristics of local dentists, and non-price determinants of demand (income, public assistance, and epidemiological factors).
The model is tested using county-level data from the Wisconsin dental sector. The estimated regression model is then used to identify areas where dentist shortages or surpluses exist, based on market conditions. These market-based imbalances are compared with simple access measures such as the dentist-to-population (D/P) ratio. Low D/P ratios are unreliable indicators of market-based shortages, but even if the D/P ratio is the selected measure of access, estimates of market imbalances can help policymakers evaluate the feasibility of attracting dentists to areas with low D/P ratios.
Learning Objectives: 1. Identify economic and noneconomic factors that potentially influence the geographic distribution of dentists. 2. Distinguish between market-based measures of dental care provider shortages and traditional measures of access, such as the dentist-to-population ratio. 3. Understand how market-based measures of market imbalances can be used by policymakers to evaluate the feasibility of attracting dentists to areas with low dentist-to-population ratios.
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.