Physician manpower ; Demand maximiziation ; Geographic distribition ; Central place theory ; Tobit regression analysis
Abstract
This study provides an empirical analysis of location competition for demand maximization by central place theory among physicians in nonmetropolitan areas of Korea. The results show that the primary care physicians distribute themselves evenly from urban communities to rural communities. The subspecialists, however, cluster together in major cities rather than decentralize themselves in rural countries. This study establishes the three statistical models : primary care physicians, subspecialist physicians, and total physicians. Two models of primary care physicians and total physicians have a strong significance in multiple regression analysis (p=0.0001). The primary care model explains approximately 45% of the variation and the total physicians model explains approximately 70% of the variation in physician /1,000 population ratios across national counties. The subspecialist physicians mode1 analyze the tobit regression because of the left censored and truncated values(57 cases = 0). In all three models, analysis of the coefficients for physician centralization degrees in the 0- to 5- and 5- to 10-km rings around the core county reveals each a positive and negative association between these degrees and the physician /1,000 population ratios in the core county. Also, the results provide moderate evidence that the relationship between clinic physicians md community hospitals is competitive, and the relationship between clinic physicians and pharmaceutists is synergistic. This suggests that public policy makers and local self-governing bodies must take an active role to ensure provider availability and the regional health planning in all nonmetropolitan areas of Korea.