How to Attract Physicians to Underserved Areas? Policy Recommendations from a Structural Model
Review of Economics and Statistics · 2024 · Francisco Costa、Letícia Nunes、Fabio Miessi Sanches
中文摘要
本文利用2001至2013年间毕业于巴西医学院的所有全科医生的执业地点选择,研究旨在提高医疗服务不足地区医生供给的政策。我们构建并估计了一个医生供给与需求模型,其中医生的区位偏好采用随机系数离散选择模型进行估计。在需求方,私立机构与遍布全国的私立和公立医疗机构竞争医生。政策反事实模拟表明,医学院面向出生于医疗服务不足地区学生的配额制,以及在贫困地区医学院增设招生名额,比经济激励更具成本效益。
Abstract
This paper exploits location choices of all generalist physicians who graduated in Brazil between 2001 and 2013 to study policies aimed at increasing the supply of physicians in underserved areas. We set up and estimate a supply and demand model for physicians. We estimate physicians' locational preferences using a random coefficients discrete choice model. The demand has private establishments competing for physicians with private and public facilities around the country. Policy counterfactuals indicate that quotas in medical schools for students born in underserved areas and the opening of vacancies in medical schools in deprived areas are more cost-effective than financial incentives.