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Getting Doctors into the Bush: General Practitioners' Preferences for Rural Location

Author

Listed:
  • Anthony Scott

    (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne)

  • Julia Lane

    (Department of Economics, University of Manitoba)

  • John Humphreys

    (School of Rural Health, Monash University)

  • Catherine Joyce

    (Department of Eipdemiology and Preventive Medicine, Monash University)

  • Guyonne Kalb

    (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne)

  • Sung-Hee Jeon
  • Matthew McGrail

    (School of Rural Health, Monash University)

Abstract
A key policy issue in many countries is the maldistribution of doctors across geographic areas, which has important effects on equity of access and health care costs. Many government programs and incentive schemes have been established to encourage doctors to practise in rural areas. However, there is little robust evidence of the effectiveness of such incentive schemes. The aim of this study is to examine the preferences of general practitioners (GPs) for rural location using a discrete choice experiment. This is used to estimate the probabilities of moving to a rural area, and the size of financial incentives GPs would require to move there. GPs were asked to choose between two job options or to stay at their current job as part of the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey of doctors. 3,727 GPs completed the experiment. Sixty five per cent of GPs chose to stay where they were in all choices presented to them. Moving to an inland town with less than 5,000 population and reasonable levels of other job characteristics would require incentives equivalent to 64% of current average annual personal earnings ($116,000). Moving to a town with a population between 5,000 and 20,000 people would require incentives of at least 37% of current annual earnings, around $68,000. The size of incentives depend not only on the area but also on the characteristics of the job. The least attractive rural job package would require incentives of at least 130% of annual earnings, around $237,000.

Suggested Citation

  • Anthony Scott & Julia Lane & John Humphreys & Catherine Joyce & Guyonne Kalb & Sung-Hee Jeon & Matthew McGrail, 2012. "Getting Doctors into the Bush: General Practitioners' Preferences for Rural Location," Melbourne Institute Working Paper Series wp2012n13, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    • Handle: RePEc:iae:iaewps:wp2012n13
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    References listed on IDEAS

    as
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    Cited by:

    1. Barbara Broadway & Guyonne Kalb & Jinhu Li & Anthony Scott, 2017. "Do Financial Incentives Influence GPs' Decisions to Do After‐hours Work? A Discrete Choice Labour Supply Model," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 52-66, December.
    2. Pedro Ramos & Hélio Alves & Paulo Guimarães & Maria A. Ferreira, 2017. "Junior doctors’ medical specialty and practice location choice: simulating policies to overcome regional inequalities," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(8), pages 1013-1030, November.
    3. Jon Helgheim Holte & Peter Sivey & Birgit Abelsen & Jan Abel Olsen, 2016. "Modelling Nonlinearities and Reference Dependence in General Practitioners' Income Preferences," Health Economics, John Wiley & Sons, Ltd., vol. 25(8), pages 1020-1038, August.
    4. Anthony Scott & Peter Sivey, 2022. "Motivation and competition in health care," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1695-1712, August.
    5. Gregory Merlo & Mieke Driel & Lisa Hall, 2020. "Systematic review and validity assessment of methods used in discrete choice experiments of primary healthcare professionals," Health Economics Review, Springer, vol. 10(1), pages 1-9, December.
    6. Pestana, Joana & Frutuoso, João & Costa, Eduardo & Fonseca, Filipa, 2024. "Heterogeneity in physician's job preferences in a dual practice context – Evidence from a DCE," Social Science & Medicine, Elsevier, vol. 343(C).
    7. Thai, Thao & Lancsar, Emily & Spinks, Jean & Freeman, Christopher & Chen, Gang, 2024. "Understanding Australian pharmacy degree holders’ job preferences through the lens of motivation-hygiene theory," Social Science & Medicine, Elsevier, vol. 348(C).
    8. Ou Yang & Peter Sivey & Andrea M. de Silva & Anthony Scott, 2016. "Preschool Children’s Demand for Sugar Sweetened Beverages: Evidence from Stated-Preference Panel Data," Melbourne Institute Working Paper Series wp2016n25, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    9. Mandeville, Kate L. & Ulaya, Godwin & Lagarde, Mylène & Muula, Adamson S. & Dzowela, Titha & Hanson, Kara, 2016. "The use of specialty training to retain doctors in Malawi: A discrete choice experiment," Social Science & Medicine, Elsevier, vol. 169(C), pages 109-118.
    10. Huynh, Elisabeth & Swait, Joffre & Lancsar, Emily, 2022. "Modelling online job search and choices of dentists in the Australian job market: Staged sequential DCEs and FIML econometric methods," Journal of choice modelling, Elsevier, vol. 44(C).
    11. Yong, Jongsay & Scott, Anthony & Gravelle, Hugh & Sivey, Peter & McGrail, Matthew, 2018. "Do rural incentives payments affect entries and exits of general practitioners?," Social Science & Medicine, Elsevier, vol. 214(C), pages 197-205.
    12. Probst, Markus, 2021. "Ohne Moos nichts los? Eine Discrete-Choice-Analyse der Präferenzen von Medizinstudenten für die Arbeit auf dem Land [No Mon, No Fun? A Discrete Choice Analysis of the Preferences of Medical Student," Junior Management Science (JUMS), Junior Management Science e. V., vol. 6(3), pages 507-546.
    13. Swami, Megha & Scott, Anthony, 2021. "Impact of rural workforce incentives on access to GP services in underserved areas: Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 281(C).
    14. Li, Jinhu & Scott, Anthony & McGrail, Matthew & Humphreys, John & Witt, Julia, 2014. "Retaining rural doctors: Doctors' preferences for rural medical workforce incentives," Social Science & Medicine, Elsevier, vol. 121(C), pages 56-64.
    15. Feder-Bubis, Paula & Bin-Nun, Gabi & Zarhin, Dana & Sherf, Michael & Heiman-Neuman, Nitza, 2023. "Residents' choice of a placement in periphery hospitals in Israel: The significance of personal/family and professional considerations," Health Policy, Elsevier, vol. 132(C).
    16. Siegel, Martin & Koller, Daniela & Vogt, Verena & Sundmacher, Leonie, 2016. "Developing a composite index of spatial accessibility across different health care sectors: A German example," Health Policy, Elsevier, vol. 120(2), pages 205-212.
    17. Mehdi Ammi & Christine Peyron, 2016. "Heterogeneity in general practitioners’ preferences for quality improvement programs: a choice experiment and policy simulation in France," Health Economics Review, Springer, vol. 6(1), pages 1-11, December.
    18. Holte, Jon Helgheim & Kjaer, Trine & Abelsen, Birgit & Olsen, Jan Abel, 2015. "The impact of pecuniary and non-pecuniary incentives for attracting young doctors to rural general practice," Social Science & Medicine, Elsevier, vol. 128(C), pages 1-9.
    19. Vikas Soekhai & Esther W. Bekker-Grob & Alan R. Ellis & Caroline M. Vass, 2019. "Discrete Choice Experiments in Health Economics: Past, Present and Future," PharmacoEconomics, Springer, vol. 37(2), pages 201-226, February.
    20. Ou Yang & Peter Sivey & Andrea M. de Silva & Anthony Scott, 2020. "Parents' Demand for Sugar Sweetened Beverages for Their Pre‐School Children: Evidence from a Stated‐Preference Experiment," American Journal of Agricultural Economics, John Wiley & Sons, vol. 102(2), pages 480-504, March.

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    More about this item

    Keywords

    Discrete choice experiment; incentives; physicians; primary care; rural;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy
    • J28 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Safety; Job Satisfaction; Related Public Policy
    • J33 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Compensation Packages; Payment Methods
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • R53 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Regional Government Analysis - - - Public Facility Location Analysis; Public Investment and Capital Stock

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