Author:
Bell J. Jason,Lee Sanghak,Gruca Thomas S.
Abstract
Clinical outreach is a crucial but understudied health care service delivery model. Physicians staffing rural outreach clinics must allocate a limited resource (i.e., their time) between caring for patients at their main sites and outreach locations. Using a unique 30-year data set of decisions made by cardiologists, the authors estimate a constrained utility maximization model of time allocations across home and outreach locations. The results show that travel distance, potential competition, and patient demand for cardiology services significantly influence allocation decisions. This structural model is used to simulate the impact of a predicted reduction in cardiologist supply. The expected impacts are unevenly distributed, with some rural locations experiencing large decreases in access. The authors evaluate two policies to restore rural access: targeted immigration and a subsidy program. A subsidy program with an estimated annual cost of $406,000 can restore outreach after a 10% reduction in cardiologist supply. This option should be preferred to recruiting and supporting five additional cardiologists under a targeted immigration strategy. This research demonstrates the value of marketing modeling in addressing limited access to health care services and evaluating alternative policies for maintaining access in the face of coming physician shortages.
Subject
Marketing,Business and International Management
Reference59 articles.
1. American Association of Medical Colleges (2019), using data from the American Medical Association, “Number of People per Active Physician by Specialty, 2019,” (accessed August 24, 2023), https://www.aamc.org/about-us/mission-areas/health-care/workforce-studies/data/number-people-active-physician-specialty-2019.
2. US Cardiologist Workforce From 1995 To 2007: Modest Growth, Lasting Geographic Maldistribution Especially In Rural Areas
3. Trends in Physician Referrals in the United States, 1999-2009
4. Distribution of Physician Specialties by Rurality
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