Junior doctors’ medical specialty and practice location choice: simulating policies to overcome regional inequalities

Pedro Ramos (), Hélio Alves, Paulo Guimaraes and Maria A. Ferreira
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Pedro Ramos: Universidade de São Paulo
Hélio Alves: University of Porto
Maria A. Ferreira: University of Porto

The European Journal of Health Economics, 2017, vol. 18, issue 8, No 7, 1013-1030

Abstract: Abstract There are nowadays over 1 million Portuguese who lack a primary care physician. By applying a discrete choice experiment to a large representative sample of Portuguese junior doctors (N = 503) in 2014, we provide an indication that this shortage may be addressed with a careful policy design that mixes pecuniary and non-pecuniary incentives for these junior physicians. According to our simulations, a policy that includes such incentives may increase uptake of general practitioners (GPs) in rural areas from 18% to 30%. Marginal wages estimated from our model are realistic and close to market prices: an extra hour of work would require an hourly wage of 16.5€; moving to an inland rural setting would involve an increase in monthly income of 1.150€ (almost doubling residents’ current income); a shift to a GP career would imply an 849€ increase in monthly income. Additional opportunities to work outside the National Health Service overcome an income reduction of 433€. Our simulation predicts that an income increase of 350€ would lead to a 3 percentage point increase in choice probability, which implies an income elasticity of 3.37, a higher estimation compared to previous studies.

Keywords: Medical specialty choice; Discrete choice experiment; Location decision; Rural uptake policies; Portugal (search for similar items in EconPapers)
JEL-codes: I18 J3 (search for similar items in EconPapers)
Date: 2017
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Citations: View citations in EconPapers (3)

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DOI: 10.1007/s10198-016-0846-6

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