Projection of the future supply of physician services has attracted considerable
attention all over the world, especially in North America and Europe. Supply
projections, however, have not taken into account physicians’ patterns of service
provision. To date, no research on supply projections has examined the relative
contribution to supply life-cycle activity patterns of physicians.
This study examined the life-cycle activity patterns of two groups of non-postgraduate
Directory Active fee-for-service physicians in British Columbia who had
practised medicine for the period 1974-84 or 1980-84. Practice activity, the dependent
variable, was measured by fee-adjusted payments made to individual physicians. Practice
activity was conceptualized to be influenced by three groups of interrelated factors--
personal, professional, and environmental--each comprised of a number of distinct
contributory variables. Data analyses included descriptive, logistical regression and time-series/
cross-section regression methods.
The time-series/cross-section regression results showed that about 35% of the
variance in practice activity could be explained by all variables except past practice
activity. Including this variable in the regression equations increased the variances
explained to about 90%. Specialty- and sex-specific analyses showed that variances
explained by the three factors, and especially the variables comprising each of the
factors, varied considerably. The personal factor accounted for most of the variances;
the contributions of the professional factor were very small, while those of the
environmental factor were negligible. A low previous year’s income emerged as the best
predictor of self-declared retirement. Most GPs, medical, and surgical specialists retired
long after the usual retirement age of 65 years. The practice activity of female GPs and
medical specialists was significantly lower than those of their male counterparts; this
observation did not apply to female surgical specialists. Sex-specific results showed that
activity levels and patterns of childbearing-aged females did not differ significantly from
their non-childbearing aged counterparts.
The research provides comprehensive data on the major variables influencing physician activity in a setting with comprehensive, universal, first
dollar health care insurance. It also offers many insights for those interested in policy
respecting physician supply and requirements, physician retirement patterns, and sex- and
specialty-specific differences in practice patterns.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:BVAU.2429/3069 |
| Date | 11 1900 |
| Creators | Kruger, Mary B. |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Relation | UBC Retrospective Theses Digitization Project [http://www.library.ubc.ca/archives/retro_theses/] |
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