This study reports some new evidence on the impact of medical care, socioeconomic, lifestyle and environmental factors on the health status of the population of the USA. The results show that additional medical care utilization is relatively ineffective in lowering mortality and increasing life expectancy. The most important factors that influence death rates are related to socioeconomic status and lifestyle. The results suggest that health care policy which focuses primarily on the provision of medical care services and ignores larger economic and social considerations may do little to benefit the nation's health.
An ongoing debate exists among health care researchers about the mechanism that allocates physicians across medical specialties, and appropriate policy measures to correct imbalances that may arise from time to time. Most researchers believe that choice of residency program by medical school graduates is key to understanding how physicians are distributed across specialties, but there is much disagreement about whether economic or non-economic factors are most influential in determining this choice. We undertake an empirical investigation of two potentially important economic factors: income and leisure. To do so, we specify a two way error component regression model to estimate the effects of expected earnings and available leisure time, and uncertainty of earnings and leisure, on specialty choices of medical residents. Our findings indicate that economic factors are an important influence in the specialty choice process; in particular, medical residents are attracted to specialties that offer the prospect of longer and more certain annual vacations, higher earnings, shorter residency programs, and more certain work schedules. Our results suggest that employment contracts that provide generous annual vacation time and promise regular weekly work schedules may be more effective than increased earnings in correcting the current perceived shortage of primary care physicians.
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