Does the under- or overrepresentation of minority physicians across geographical areas affect the location decisions of minority physicians?

摘要

OBJECTIVE: To determine whether variation in the representation of minority physicians across geographical areas in California affects the location decisions of minority physicians. DATA SOURCES: We analyzed data on 9,806 residents and 53,606 patient-care physicians from the 1997-2003 American Medical Association Masterfiles for California along with data from the California Department of Finance, RAND, and other sources. STUDY DESIGN: We estimated departure models using linear probability models and destination models using conditional logit. Each model controlled for physician and county characteristics. Parameters of interest include the interactions of physician race/ethnicity with area-level minority physician representation for the corresponding race/ethnicity. PRINCIPAL FINDINGS: Departure models show that black and Hispanic physicians are more likely to remain in an area as the level of representation of physicians from their respective groups worsens. The destination models show that black, Asian, and Hispanic physicians tend to move to areas where the level of representation is similar to that of their previous location. CONCLUSIONS: Black and Hispanic physicians are influenced by the level of representation of physicians from their respective groups in their location decisions and tend to locate where needed.