Skip to main content
Swiss Journal of Economics and Statistics
Download PDF

The Evolution of Physician Density in Switzerland

Swiss Journal of Economics and Statistics volume 144, pages 247–282 (2008)Cite this article

Summary

Our paper investigates the geographical distribution of physicians across the Swiss cantons over the years 1960 to 2005. We use a physician location model relating physician growth in a canton related to (i) the existing number of physicians in an area, (ii) commonly used determinants of the demand for physician services such as population growth, per capita income and age, and (iii) factors that determine the medical infrastructure of an area, i.e. the number of hospital beds and the existence of a university hospital. We analyze the effects separately for general practitioners and specialists and find that the two physician types react differently to certain factors included in our analysis.

References

  • Bhargava, A., L. Franzini and W. Narendranathan (1982), “Serial Correlation and the Fixed Effects Model”, Review of Economic Studies, 49 (4), pp. 533–549.

    Article  Google Scholar 

  • Bolduc, D., B. Fortin and M. A. Fournier (1996), “The Effect of Incentive Policies on the Practice Location of Doctors: A Multinomial Probit Analysis”, Journal of Labor Economics, 14, pp. 703–732.

    Article  Google Scholar 

  • Busato A. and B. Kuenzi (2008), “Primary Care Physician Supply and Other Key Determinants of Health Care Utilization: The Case of Switzerland”, BMC Health Services Research, 2008, 8:8.

    Article  Google Scholar 

  • Chomitz, K. M., G. Setiadi, A. Azwar, I. Nusye and R. Widiyarti (1998), What Do Doctors Want? Developing Incentives for Doctors to Serve in Indonesia’s Rural Areas, World Bank, Development Research Group.

  • Cooper, R. A., T. E. Getzen, H. J. McKee and P. Laud (2002), “Economic and Demographic Trends Signal an Impeding Physician Shortage”, Health Affairs, 21, pp. 140–154.

    Article  Google Scholar 

  • Dartmouth Medical School (2007), The Dartmouth Atlas of Health Care in the United States. Chicago: American Hospital Publishing.

    Google Scholar 

  • De Jaegher, K. and M. Jegers (2000), “A Model of Physician Behaviour with Demand Inducement”, Journal of Health Economics, 19, pp. 231–258.

    Article  Google Scholar 

  • Domenighetti, G. and L. Crivelli (2001), «Sécurité de l’approvisionnement en médecine de ville dans le cadre de la suppression de l’obligation de contracter», Working paper MecoP and iems.

  • Fisher E. S. and J. E. Wennberg (2003), “Health Care Quality, Geographic Variations, and the Challenge of Supply-Sensitive Care”, Perspectives in Biology and Medicine, 46, pp. 69–78.

    Article  Google Scholar 

  • Folland, S., A. C. Goodman and M. Stano (2001), The Economics of Health and Health Care, 3rd. ed., Upper Saddle River: Prentice-Hall.

    Google Scholar 

  • Foster, S. A. and W. L. Gorr (1992), “Federal Health Care Policy and the Geographic Diffusion of Physicians: A Macro-Scale Analysis”, Policy Sciences, 25, pp. 117–134.

    Article  Google Scholar 

  • Gilliand, P. and P. Eichenberger (1981), „Demographie der künftigen Ärzteschaft in der Schweiz: Perspektiven und ihre Auswirkungen auf lange Sicht“ (Demography of Future Physicians: Perspectives and Effects in the Long-term), Schweizerische Ärztezeitung, 62 (38), pp. 2759–2770.

    Google Scholar 

  • Hasler N. and M. Reichert (2008), „Einkommensentwicklung der freien Ärzteschaft der Schweiz in den Jahren 2004 (neu) und 2003 (Re-Evaluation)“, Schweizerische Ärztezeitung, 89:6.

    Google Scholar 

  • Hurley, J. (1990), “Simulated Effects of Incomes-Based Policies on the Distribution of Physicians”, Medical Care, 28, pp. 221–238.

    Article  Google Scholar 

  • Koenig L., J. M. Siegel, A. Donson, K. Hearle, S. Ho and R. Rudowitz (2003), “Drivers of Healthcare Expenditures Associated with Physician Services”, The American Journal of Managed Care, 9 (Special Issue 1), pp. SP34–42.

    Google Scholar 

  • Kristiansen, I. S. and O. H. Førde (1992), “Medical Specialists’ Choice of Location: The Role of Geographical Attachement in Norway”, Social Science and Medicine, 34, pp. 57–62.

    Article  Google Scholar 

  • Labelle, R., G. Stoddart and T. Rice (1994), “A Re-Examination of the Meaning and Importance of Supplier-Induced Demand”, Journal of Health Economics, 13, pp. 347–368.

    Article  Google Scholar 

  • Newhouse, J. P., A. P. Williams, B. W. Bennett and W. B. Schwartz (1982), “Does the Geographical Distribution of Physicians Reflect Market Failure?”, Bell Journal of Economics, 13 (2), pp. 493–505.

    Article  Google Scholar 

  • Schellhorn, M. (2001), “The Effect of Variable Health Insurance Deductibles on the Demand for Physician Visits”, Health Economics, 10, pp. 441–456.

    Article  Google Scholar 

  • Schmid, H. (1984), „Der Einfluss zunehmender Ärztedichte auf die Kosten der Krankenversicherung“ (Influence of an Increasing Physician Density on the Cost of Health Insurance), Schweizerische Ärztezeitung, 65 (11), pp. 497–506.

    Google Scholar 

  • Timmermans, H. and R. G. Golledge (1990), “Applications of Behavioural Research on Spatial Problem II: Preference and Choice”, Progress in Human Geography, 14, pp. 311–354.

    Article  Google Scholar 

  • U.S. Department of Health and Human Services (2006), Physician Supply and Demand: Projections to 2020.

  • Wagstaff, A. (1986), “The Demand for Health. Some New Empirical Evidence”, Journal of Health Economics, 5, pp. 195–233.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Financial Services Zug IFZ, Lucerne University of Applied Sciences and Arts, Grafenauweg 10, CH-6304, Zug, Switzerland

    Gabrielle Wanzenried

  2. Foundation Swiss School of Public Healthplus, Zurich, Switzerland

    Sandra Nocera

Authors
  1. Gabrielle Wanzenried
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sandra Nocera
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gabrielle Wanzenried.

Additional information

We would like to thank Mike Gerfin, Bronwyn H. Hall, Robert E. Leu, Markus König, Heather Murray, Heidi Seney, Roland Unternährer, participants of the EARIE Conference 2002, Madrid, the World Congress of the International Health Economics Association 2003, San Francisco, and the annual conference of the Verein für Socialpolitik 2005 in Bonn and an anonymous referee for helpful suggestions and comments and the Swiss Federal Statistical Office for data provision. Gabrielle Wanzenried acknowledges financial support of the Swiss National Science Foundation. All errors are our sole responsibility.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 2.0 International License ( https://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and permissions

About this article

Cite this article

Wanzenried, G., Nocera, S. The Evolution of Physician Density in Switzerland. Swiss J Economics Statistics 144, 247–282 (2008). https://doi.org/10.1007/BF03399254

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03399254

Keywords

JEL-Classification