scholarly journals What Explains the Regional Variation in the Use of General Practitioners in Australia?

2020 ◽  
Author(s):  
Chunzhou Mu ◽  
Jane Hall
Keyword(s):  
Health Care ◽  
Population Health ◽  
General Practitioners ◽  
Regional Variation ◽  
Regional Differences ◽  
Outcome Variable ◽  
Supply Side ◽  
Demand Side ◽  
Gp Visits ◽  
Supply Side Factors

Abstract Background: Regional variation in the use of health care services is widespread. Identifying and understanding the sources of variation and how much variation is unexplained can inform policy interventions to improve the efficiency and equity of health care delivery. Methods: We examined the regional variation in the use of general practitioners (GPs) using data from the Social Health Atlas of Australia by Statistical Local Area (SLAs). 756 SLAs were included in the analysis. The outcome variable of GP visits per capita by SLAs was regressed on a series of demand-side factors measuring population health status and demographic characteristics and supply-side factors measuring access to physicians. Each group of variables was entered into the model sequentially to assess their explanatory share on regional differences in GP usage. Results: Both demand-side and supply-side factors were found to influence the frequency of GP visits. Specifically, areas in urban regions, areas with a higher percentage of the population who are obese, who have profound or severe disability, and who hold concession cards, and areas with a smaller percentage of the population who reported difficulty in accessing services have higher GP usage. The availability of more GPs led to higher use of GP services while the supply of more specialists reduced use. 30.56% of the variation was explained by medical need. Together, both need-related and supply-side variables accounted for 32.24% of the regional differences as measured by the standard deviation of adjusted GP-consultation rate. Conclusions: There was substantial variation in GP use across Australian regions with only a small proportion of them being explained by population health needs, indicating a high level of unexplained clinical variation. Supply factors did not add a lot to the explanatory power. There was a lot of variation that was not attributable to the factors we could observe. This could be due to more subtle aspects of population need or preferences and therefore warranted. However, it could be due to practice patterns or other aspects of supply and be unexplained. Future work should try to explain the remaining unexplained variation.

scholarly journals What Explains the Regional Variation in the Use of General Practitioners in Australia?

2019 ◽  
Author(s):  
Chunzhou Mu ◽  
Jane Hall
Keyword(s):  
Health Care ◽  
Population Health ◽  
General Practitioners ◽  
Regional Variation ◽  
Regional Differences ◽  
Outcome Variable ◽  
Supply Side ◽  
Demand Side ◽  
Gp Visits ◽  
Supply Side Factors

Abstract Background: Regional variation in the use of health care services is widespread. Identifying and understanding the sources of variation and how much variation is unwarranted can inform policy interventions to improve the efficiency and equity of health care delivery. Methods: We examined the regional variation in the use of general practitioners (GPs) using data from the Social Health Atlas of Australia by Statistical Local Area (SLAs). 756 SLAs were included in the analysis. The outcome variable of GP visits per capita by SLAs was regressed on a series of demand-side factors measuring population health status and demographic characteristics and supply-side factors measuring access to physicians. Each group of variables was entered into the model sequentially to assess their explanatory share on regional differences in GP usage. Results: Both demand-side and supply-side factors were found to influence the frequency of GP visits. Specifically, areas in urban regions, areas with a higher percentage of the population who are obese, who have profound or severe disability, and who hold concession cards, and areas with a smaller percentage of the population who reported difficulty in accessing services have higher GP usage. The availability of more GPs led to higher use of GP services while the supply of more specialists reduced use. 30.56% of the variation was explained by medical need. Together, both need-related and supply-side variables accounted for 32.24% of the regional differences as measured by the standard deviation of adjusted GP-consultation rate. Conclusions: There was substantial variation in GP use across Australian regions with only a small proportion of them being explained by population health needs, indicating a high level of unwarranted clinical variation. Supply factors did not add a lot to the explanatory power. There was a lot of variation that was not attributable to the factors we could observe. This could be due to more subtle aspects of population need or preferences and therefore warranted. However, it could be due to practice patterns or other aspects of supply and be unwarranted. Future work should try to explain the remaining unexplained variation. Keywords : GP usage, Regional variation, Statistical Local Areas, Australia

scholarly journals What Explains the Regional Variation in the Use of General Practitioners in Australia?

2020 ◽  
Author(s):  
Chunzhou Mu ◽  
Jane Hall
Keyword(s):  
Health Care ◽  
Population Health ◽  
General Practitioners ◽  
Regional Variation ◽  
Regional Differences ◽  
Outcome Variable ◽  
Supply Side ◽  
Demand Side ◽  
Gp Visits ◽  
Supply Side Factors

Abstract Background: Regional variation in the use of health care services is widespread. Identifying and understanding the sources of variation and how much variation is unexplained can inform policy interventions to improve the efficiency and equity of health care delivery. Methods: We examined the regional variation in the use of general practitioners (GPs) using data from the Social Health Atlas of Australia by Statistical Local Area (SLAs). 756 SLAs were included in the analysis. The outcome variable of GP visits per capita by SLAs was regressed on a series of demand-side factors measuring population health status and demographic characteristics and supply-side factors measuring access to physicians. Each group of variables was entered into the model sequentially to assess their explanatory share on regional differences in GP usage. Results: Both demand-side and supply-side factors were found to influence the frequency of GP visits. Specifically, areas in urban regions, areas with a higher percentage of the population who are obese, who have profound or severe disability, and who hold concession cards, and areas with a smaller percentage of the population who reported difficulty in accessing services have higher GP usage. The availability of more GPs led to higher use of GP services while the supply of more specialists reduced use. 30.56% of the variation was explained by medical need. Together, both need-related and supply-side variables accounted for 32.24% of the regional differences as measured by the standard deviation of adjusted GP-consultation rate. Conclusions: There was substantial variation in GP use across Australian regions with only a small proportion of them being explained by population health needs, indicating a high level of unexplained clinical variation. Supply factors did not add a lot to the explanatory power. There was a lot of variation that was not attributable to the factors we could observe. This could be due to more subtle aspects of population need or preferences and therefore warranted. However, it could be due to practice patterns or other aspects of supply and be unexplained. Future work should try to explain the remaining unexplained variation. Keywords: GP usage, Regional variation, Statistical Local Areas, Australia

scholarly journals What Explains the Regional Variation in the Use of General Practitioners in Australia?

2019 ◽  
Author(s):  
Chunzhou Mu ◽  
Jane Hall
Keyword(s):  
Health Care ◽  
Population Health ◽  
General Practitioners ◽  
Regional Variation ◽  
Regional Differences ◽  
Outcome Variable ◽  
Supply Side ◽  
Demand Side ◽  
Gp Visits ◽  
Supply Side Factors

Abstract Background: Regional variation in the use of health care services is widespread. Identifying and understanding the sources of variation and how much variation is unwarranted can inform policy interventions to improve the efficiency and equity of health care delivery. Methods: We examined the regional variation in the use of general practitioners (GPs) using data from the Social Health Atlas of Australia by Statistical Local Area (SLAs). 756 SLAs were included in the analysis. The outcome variable of GP visits per capita by SLAs was regressed on a series of demand-side factors measuring population health status and demographic characteristics and supply-side factors measuring access to physicians. Each group of variables was entered into the model sequentially to assess their explanatory share on regional differences in GP usage. Results: Both demand-side and supply-side factors were found to influence the frequency of GP visits. Specifically, areas in urban regions, areas with a higher percentage of the population who are obese, who have profound or severe disability, and who hold concession cards, and areas with a smaller percentage of the population who reported difficulty in accessing services have higher GP usage. The availability of more GPs led to higher use of GP services while the supply of more specialists reduced use. 30.56% of the variation was explained by medical need. Together, both need-related and supply-side variables accounted for 32.24% of the regional differences as measured by the standard deviation of adjusted GP-consultation rate. Conclusions: There was substantial variation in GP use across Australian regions with only a small proportion of them being explained by population health needs, indicating a high level of unwarranted clinical variation. Supply factors did not add a lot to the explanatory power. There was a lot of variation that was not attributable to the factors we could observe. This could be due to more subtle aspects of population need or preferences and therefore warranted. However, it could be due to practice patterns or other aspects of supply and be unwarranted. Future work should try to explain the remaining unexplained variation.

scholarly journals EMPIRICAL ANALYSIS ON THE DETERMINANTS OF URBAN PARKS

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Kenichi SHIMAMOTO
Keyword(s):  
Panel Data Analysis ◽  
Urban Parks ◽  
Well Being ◽  
Supply Side ◽  
Demand Side ◽  
Financial Strength ◽  
Level Data ◽  
Determining Factors ◽  
Park Area ◽  
Supply Side Factors

Urban parks play an important role in enhancing the lifestyle of the community by providing functions which support the environment, safety, health and ell-being. This paper will examine what the determining factors are for the development of urban parks, taking into consideration the supply side and demand side factors and past conditions of urban parks. Japan prefecture level data between 2001 to 2014 will be applied to a panel data analysis. The results find that for the supply side factors, the share of gross production by the construction industry and the financial strength of the local government; and on the demand side factors, preference towards the environment, health and well-being, have impact on the urban park area per capita at a statistically significant level.

scholarly journals Industrial Policy in Britain since 1970: Changing Values, Assumptions and Mechanisms

2017 ◽  
Vol 58 (1) ◽  
pp. 35-57
Author(s):  
Martin Chick
Keyword(s):  
Industrial Policy ◽  
Capital Investment ◽  
Supply Side ◽  
Demand Side ◽  
Role Of Government ◽  
Market Inefficiency ◽  
Quality Of Supply ◽  
Supply Side Factors

Abstract This article examines the change in the fundamental assumptions underpinning industrial policy from the mid-1970s in Britain. It necessarily contrasts the broadly supply-side concerns of industrial policy from the mid-1970s with the more demand-side concerns of the earlier ‘Golden Age’ period from 1945. Where in the earlier period the emphasis in industrial policy was on capital investment and the role of government in compensating for perceived market inefficiency, from the late 1970s this emphasis shifted to the need to improve the flexibility and quality of supply-side factors allied to a more optimistic view of the ability of the market to secure efficient outcomes.

scholarly journals Supply-Side and Demand-Side Cost Sharing in Health Care

1993 ◽  
Vol 7 (4) ◽  
pp. 135-151 ◽  
Author(s):  
Randall P Ellis ◽  
Thomas G McGuire
Keyword(s):  
Health Care ◽  
Cost Sharing ◽  
Health Care Services ◽  
Financial Risk ◽  
Supply And Demand ◽  
Supply Side ◽  
Demand Side ◽  
Health Care Demand ◽  
Financial Risk Protection ◽  
Long Run

In health markets, the price paid by insured consumers when health care services are demanded can be set separately from the price paid to providers when services are supplied. This fact suggests two alternate strategies for controlling the costs of health care: demand-side cost sharing, where patients must pay more in co-payments or deductibles, and supply-side cost sharing, which seeks to alter the incentives of health care workers to provide certain services. We review the rationale, limits, and comparative advantage of demand- and supply-side cost sharing in health care while primarily focusing on the short-run pursuit of consumer financial risk protection and efficiency. We then turn briefly to the long-run issue of technology adoption, as well as the how supply- and demand-side cost sharing may affect the fairness of the health system.

scholarly journals A measure of competitive access to destinations for comparing across multiple study regions

2019 ◽  
Author(s):  
Jeff Allen ◽  
Steven Farber
Keyword(s):  
Travel Behavior ◽  
Regional Differences ◽  
Transportation Networks ◽  
Spatial Interaction ◽  
Market Competition ◽  
Supply And Demand ◽  
Urban Systems ◽  
Supply Side ◽  
Demand Side ◽  
Interaction Modeling

Accessibility is now a common way to measure the benefits provided by transportation–land use systems. Despite its widespread use, few measurement options allow for the comparison of accessibility across multiple urban systems, and most do not adequately control for market competition between demand‐side actors and supply‐side facilities in localized markets. In this article, we develop a measure of competitive access to destinations that can be used to accurately compare accessibility between regions. This measure stems from spatial interaction modeling and accounts for competition at both the supply and demand sides of analysis, regional differences in transportation networks and travel behavior, and any imbalance between the size of the population and the number of opportunities. We use this method to compute access to employment for Canada's eight largest cities to comparatively examine inequalities in accessibility, both within and between cities, and by travel mode.

scholarly journals Demand without Supply: Populist Attitudes without Salient Supply-Side Factors of Populism

2021 ◽  
pp. 1-21
Author(s):  
Mike Medeiros
Keyword(s):  
Present Article ◽  
Political Discourse ◽  
Vote Choice ◽  
Supply Side ◽  
Demand Side ◽  
Federal Election ◽  
Electoral Success ◽  
Fertile Ground ◽  
Attitudinal Dimension ◽  
Supply Side Factors

Abstract Populism's electoral success has been linked to socio-economic crises and to inflammatory political discourse. However, little is known of populist attitudes in contexts in which these supply-side factors are not salient. The present article diverges from the conception of populism that sees it as being activated or fuelled by contextual factors and, rather, conceives populism as an ideological attitudinal dimension that can have an impact on vote choice when supply-side factors are not salient. Using the particular context of the 2015 Canadian federal election as a case to test this theory, empirical analyses support this conception of populism by demonstrating that populist attitudes can be relatively prominent and even impact vote choice in a setting in which the traditional supply-side factors to activate or fuel populism are not salient. Ultimately, populism is shown to be an important demand-side attitudinal dimension even when there is little or no fertile ground for it.

scholarly journals How is patient activation related to healthcare service utilisation? Evidence from electronic patient records in England

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feifei Bu ◽  
Daisy Fancourt
Keyword(s):  
Health Care ◽  
Healthcare Service ◽  
Patient Activation ◽  
Outcome Variable ◽  
Service Utilisation ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Emergency Admissions ◽  
Gp Visits

Abstract Background There is increasing awareness of the importance of patient activation (knowledge, skills, and confidence for managing one’s health and health care) among clinicians and policy makers, with emerging evidence showing higher levels of patient activation are associated with better health outcomes and experiences of health care. This study aimed to examine the association between patient activation and a wide range of specific types of healthcare service utilisation in England, including GP and non-GP primary care, elective and emergency hospital admissions, outpatient visits, and attendances at the Accident and Emergency department. Methods Data were derived from linked electronic patient records collected by primary and secondary healthcare providers in North West London between January 2016 and November 2019. Our analyses focused on adults (18+) with a valid Patient Activation Measure (PAM). After excluding patients with missing data, we had an analytical sample of 15,877 patients. Data were analysed using negative binomial regression and logistic regression models depending on the outcome variable. Results Patients had a mean activation score of 55.1 and a standard deviation (SD) of 17.7 (range: 0–100). They had an average of 5.4 GP visits (SD = 8.0), 26.8 non-GP visits (SD = 23.4) and 6.0 outpatient attendances (SD = 7.9) within a one-year follow-up. About 24.7% patients had at least one elective admission, 24.2% had one or more emergency admissions, and 42.3% had one or more A&E attendance within the follow-up. After accounting for a number of demographic and health factors, we found a linear (or proximately linear) association between patient activation and the number of GP visits, emergency admissions and A&E attendance, but a non-linear relationship between patient activation and the number of non-GP visits, the number of outpatient attendance and elective inpatient admission. Conclusions This study has provided strong empirical evidence from England linking patient activation with healthcare service utilisation. It suggests the value of supporting patient activation as a potential pathway to ease the burden of healthcare system.

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