More on health care paradoxes

Abstract

ParadoxesA B S T R A C T Federal and state government efforts to improve the nation"s health focus particular attention on the necessity of increasing the numbers of physicians. Yet, evidence from several studies suggest weak linkages between health and the number of physicians. The present study surveys civilian health and the number of physicians during the period of national mobilization in the U.S. in the 1940's. This period, where low physician/population ratios prevailed for several years, is unique in recent history and provides a useful reference for current health policy. Reduced numbers of physicians are shown to have had a measurable negative impact on civilian health over the period.* The author would like to express gratitude to the Brookings Institution for support and to a referee for helpful suggestions.

Explaining a health care paradox

“…7 The results are similar to those reported by Joyce [4]; when OLS is used to analyze the impact of physician density on mortality rates, a statistically insignificant negative coefficient is obtained. More accurate estimates can be obtained in two ways: taking into account Joyce's "variety of factors" by including in the regression the expected mortality rates, and by applying GLS.…”

“…4 The intensity of treatment is difficult to conceptualize and measure. However, Fuchs [9] reports that approximately two-thirds of the value of health services inputs represent labor, one-sixth capital, and the remainder goods and services purchased from other industries.…”

“…Jon M. Joyce [4] studies the effects of the "variety of factors" in order to measure more accurately the impact of a reduced number of physicians per capita on mortality rates during World War II. This study is based on a similar approach: observed mortality rates for a single case-type are explained by means of an objective measure of population risk, and number of accessible specialist physicians per case.…”