Rural-urban locational choices of medical doctors: a county-level analysis
1996
Goetz, S.J. | Debertin, D.L.
Recent changes in the medical profession have contributed to reductions in the number of doctors locating in rural areas. This study identifies county-level factors influencing locational choices of medical doctors, with an emphasis on understanding the independent effect of whether a county is designated as rural or urban. Access to health care will become increasingly critical for rural residents as their average age increases, as is occurring in many farming communities. While agricultural economists have studied the provision of general services such as roads and water to rural areas, they have -- with a few notable exceptions -- neglected medical services issues. In this study, a theoretical model of income-constrained utility maximization by doctors is used to develop econometric equations for determining where doctors locate. Over 3,000 continental U.S. counties were included in the analysis. A statistical distinction is drawn between factors affecting the likelihood that doctors are present in a county, and the number of doctors per capita. Results suggest a number of public policy and private incentive strategies could be employed by individual communities to increase the supply of primary care physicians (PCPs) in rural areas. Some of these strategies are more difficult and expensive for individual communities to implement than others. PCPs are more likely to locate in counties with amenities such as recreational facilities, lower burglary rates, lower property taxes, higher spending on public education and other services, and a higher share of individuals having completed college.
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