Competition and Physician Turnover: Evidence from Swedish Primary Care Units
Abstract
The Swedish government has over the years implemented several reforms
to improve health care system and ensure continuity of care. One of the
reforms, The Act on Free Choice, was implemented between 2007 and 2010
providing patients a free choice to choose a provider and private providers to
freely enter the market; thereby, increasing the competition among providers.
This paper contributes to the limited body of literature on competition and
continuity of care by exploring the effect of increased competition on physician
turnover in Swedish primary care units in following regions, Stockholm, Västra
Götaland and Skåne, using a staggered difference-in-difference strategy applied
with Two-Way Fixed Effects and stacked regression models. This paper also
provides a survival analysis to explore the tenure of primary care physicians
and which types of primary care units accounts for the physician turnover
using the Cox Proportional Hazard and Kaplan-Meier models. Although the
effect of increased competition on physician turnover, on an aggregated level
across all regions, is modest, we observe significant effect on a regional basis
where the regions respond differently to distances. Results from our survival
analysis reveal several factors related to physicians and primary care units that
influence physician turnover. Notably, younger physicians graduating from a
Swedish medical school account for higher turnover. Moreover, primary care
units employing eight or more physicians, and having a lower average age among
physicians account for lower physician turnover.
Degree
Master 2-years
Other description
MSc in Economics
Collections
View/ Open
Date
2023-10-10Author
AY, BELIT
Series/Report no.
2023:218
Language
eng