Physician Concentration, Shortage, and Effective Health Care Service

• In Event: Health and Public Opinion

Abstract

Human capital is a key to effective service provision for a wide range of public health services that aim at improving citizen well-being. A decade after the national healthcare reform under the ACA, attention has yet to be paid to the central role of the healthcare workforce in improving the effectiveness of the healthcare system. While the healthcare reform increased Americans’ access to healthcare and public healthcare funding, paradoxically, the ability of the healthcare system to provide financially viable health services is still limited in many local areas with the physician shortage crisis. Can a healthcare system effectively deliver services in resource-constrained settings? In this research, we address the question of effective service provision by exploring the impact of human capital (physician) shortage on public health outcomes. Leveraging a unique panel dataset that tracks 3,000+ U.S. counties from 2010 to 2020, we assess how physician shortage and physician concentration adversely affect health outcomes such as mortality of Medicare patients, take-up of Medicare services, access to primary care, and the quality of health care services. In addition, we consider rural-urban location and state Medicaid expansion as two important contexts and explore if the negative impact of physician shortage is exacerbated in rural areas and counties in Medicaid expansion states.

Authors

• Austin McCrea, Texas Tech University

• Miyeon Song, Rutgers, The State University of New Jersey - Newark

• Ling Zhu, University of Houston