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Regional differences of outpatient physician supply as a theoretical economic and empirical generalized linear model
Stefan Scholz1, Johann-Matthias Graf von der Schulenburg2, Wolfgang Greiner3
1Department of Health Economics and Management, Faculty of Public Health, University of Bielefeld, Universitätsstr. 25, 33615, Bielefeld, Germany. stefan.scholz@uni-bielefeld.de.
Background:
Regional differences in physician supply can be found in many health care systems, regardless of their organizational and financial structure. A theoretical model is developed for the physicians' decision on office allocation, covering demand-side factors and a consumption time function.
Methods:
To test the propositions following the theoretical model, generalized linear models were estimated to explain differences in 412 German districts. Various factors found in the literature were included to control for physicians' regional preferences.
Results:
Evidence in favor of the first three propositions of the theoretical model could be found. Specialists show a stronger association to higher populated districts than GPs. Although indicators for regional preferences are significantly correlated with physician density, their coefficients are not as high as population density.
Conclusions:
If regional disparities should be addressed by political actions, the focus should be to counteract those parameters representing physicians' preferences in over- and undersupplied regions.
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