Location choice of general practitioners: exploring supply, mobility, and equity in Australia
AffiliationMelbourne Institute of Applied Economic and Social Research
Document TypePhD thesis
Access StatusThis item is currently not available from this repository
© 2014 Dr. Michelle McIsaac
This thesis examines the location choices and resultant distribution of general practitioners (GPs) in Australia. Specifically, horizontal equity in the distribution of GPs is examined and measured. Results suggest a moderate level of inequity across Divisions of General Practice exists. Aggregate non-pecuniary factors associated with areas of high GP concentrations are also explored. GPs appear to be located in accordance with demand, but not necessarily in areas with the highest perceived need for care. Areas with high concentrations of GPs tend to have higher socioeconomic status and be more metropolitan. High GP concentrations are also found in areas with more amenities such as hospitals and private schools. The geographical unit of measurement influences the interpretation of results, but not the robustness of results. Many independent variables are spatially correlated, with GPs located in the vicinity of private schools and in areas where there is an aggregate clustering of higher socioeconomic status and metropolitan neighbourhoods. GPs are however, located in direct proximity to hospitals and several population characteristics associated with demand. Using longitudinal data from the Medicine in Australian Balancing Employment and Life (MABEL) survey metropolitan GPs’ decision to locate in areas with low, medium, or high socioeconomic status as well as their decisions to re-locate are analysed. The results demonstrate that practice-owning and employee GPs consider factors beyond simple profit maximization when making location choices. Nonetheless, practice-owning and employee GPs place different weights on the importance of patient volume, complexity, GP density in the neighbourhood, and expected earnings. GPs tend to relocate towards neighbourhoods with similar or higher socioeconomic status, with very few GPs choosing to relocate to neighbourhoods with low socioeconomic status. Policy simulations suggest that GPs, particularly practice owning GPs, are not very responsive to pecuniary relocation incentives once an initial location decision has been made.
KeywordsGeneral Practice; health care supply; location choice; health care policy
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