More physicians: improved availability or induced demand?

Health Econ. 1998 Sep;7(6):495-508. doi: 10.1002/(sici)1099-1050(199809)7:6<495::aid-hec368>3.0.co;2-s.

Abstract

A number of empirical studies have shown that there is a negative association between population:physician ratio and utilization of medical services. However, it is not clear whether this relationship reflects supplier-inducement, the effect of lower prices on patient demand, a supply response to variation in health status, or improved availability. In Norway, patient fees and state reimbursement fees are set centrally. Therefore, the correlation between utilization and population:physician ratio either reflects supplier-inducement, a supply response or an availability effect. We applied a theoretical model which distinguished between an inducement and an availability effect. The model was implemented on a cross-sectional data set which contained information about patient visits and laboratory tests for all fee-for-service primary care physicians in Norway. Since population:physician ratio is potentially endogenous, an instrumental variable approach is used. We found no evidence for inducement either for number of visits or for provision of laboratory services.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Laboratory Techniques
  • Contract Services / statistics & numerical data
  • Cross-Sectional Studies
  • Fee-for-Service Plans / statistics & numerical data
  • Fees, Medical / statistics & numerical data
  • Health Care Surveys / methods*
  • Health Services Needs and Demand / economics
  • Health Services Needs and Demand / statistics & numerical data*
  • Humans
  • Models, Econometric*
  • Norway
  • Office Visits / statistics & numerical data
  • Physicians, Family / economics
  • Physicians, Family / supply & distribution*
  • Population Density
  • Regression Analysis