Medical College of Wisconsin
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Economic expansion is a major determinant of physician supply and utilization. Health Serv Res 2003 Apr;38(2):675-96 PMID: 12785567 PMCID: PMC1360909

Pubmed ID



OBJECTIVE: To assess the relationship between levels of economic development and the supply and utilization of physicians.

DATA SOURCES: Data were obtained from the American Medical Association, American Osteopathic Assocation, Organization for Economic Cooperation and Development (OECD), Bureau of Health Professions, Bureau of Labor Statistics, Bureau of Economic Analysis, Census Bureau, Health Care Financing Administration, and historical sources.

STUDY DESIGN: Economic development, expressed as real per capita gross domestic product (GDP) or personal income, was correlated with per capita health care labor and physician supply within countries and states over periods of time spanning 25-70 years and across countries, states, and metropolitan statistical areas (MSAs) at multiple points in time over periods of up to 30 years. Longitudinal data were analyzed in four complementary ways: (1) simple univariate regressions; (2) regressions in which temporal trends were partialled out; (3) time series comparing percentage differences across segments of time; and (4) a bivariate Granger causality test. Cross-sectional data were assessed at multiple time points by means of univariate regression analyses.

PRINCIPAL FINDINGS: Under each analytic scenario, physician supply correlated with differences in GDP or personal income. Longitudinal correlations were associated with temporal lags of approximately 5 years for health employment and 10 years for changes in physician supply. The magnitude of changes in per capita physician supply in the United States was equivalent to differences of approximately 0.75 percent for each 1.0 percent difference in GDP. The greatest effects of economic expansion were on the medical specialties, whereas the surgical and hospital-based specialties were affected to a lesser degree, and levels of economic expansion had little influence on family/general practice.

CONCLUSIONS: Economic expansion has a strong, lagged relationship with changes in physician supply. This suggests that economic projections could serve as a gauge for projecting the future utilization of physician services.

Author List

Cooper RA, Getzen TE, Laud P


Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin


2-s2.0-0038220045   79 Citations

MESH terms used to index this publication - Major topics in bold

Cross-Sectional Studies
Health Expenditures
Health Services Needs and Demand
Health Services Research
Longitudinal Studies
Models, Econometric
Regression Analysis
United States
jenkins-FCD Prod-297 dff1a717c492f00bf6291286365f1f4fe95208f1