The Male-Female Gap in Physician Earnings: Evidence from a Public Health Insurance System

Empirical evidence from U.S. studies suggests that, on average, female physicians earn less than their male counterparts. This gap in earnings does not disappear when individual and market characteristics are con- trolled for. This paper investigates whether a gender earnings difference can also be observed in a health care system predominantly financed by public insurance companies. Using a unique data set of physicians' earn- ings recorded by a public social security agency in an Austrian province between 2000 and 2004, we find a gender gap in average earnings of about 32 percent. A substantial share of this gap (20 to 47 percent) cannot be explained by individual and market characteristics, leaving labor market discrimination as one possible explanation for the observed gender earn- ings difference of physicians.Health care financing; physician earnings; wage composition

The Convergence of Health Care Financing Structures: Empirical Evidence from OECD-Countries

In this paper we concentrate on the question whether the financing structure of the health care systems converges. In a world of increasing economic integration convergence in health care financing (HCF) and, hence, decreasing differences in HCF across countries enhance individuals’ (labour) mobility and support harmonization processes. As an indicator for convergence we take the public financing ratio in % of total HCF and in % of GDP. The major finding is that HCF in the OECD countries converged in the time period 1970 – 2005. This conlusion also holds when looking at smaller sub groups of countries and shorter time periods. However, we find evidence that countries do not move towards a common mean and that the rate of convergence is decreasing over time.Convergence, health care system, health care financing

Socioeconomic Environment and Mortality: A two-level Decomposition by Sex and Cause of Death

Gender inequalities in longevity/mortality are a major area of research since the 1970s. Despite substantial insights, the questions posed and the research strategies used are still in a state of flux. In the present paper we shed some light on the question, to which extent socioeconomic variables determine the gender gap in mortality for important causes of death. Thereby we specifically focus on behavior-related causes of death. We follow an ecological approach based on aggregated mortality data from Austria both at the community and the district level covering the time period 1969 - 2004. By using weighted regression analysis (panel fixed effects, pooled and cross section) we find that higher income levels reduce male mortality in most causes of death (including malignant neoplasms and diseases of the circulatory system), while this indicator appear to be insignificant for female mortality in these causes. This indicates that the decreasing effect of the higher socioeconomic status on mortality might be canceled out by a ”gender role equalization“ effect for women due to the adoption of unhealthy life styles (e.g. smoking). This finding is also confirmed by the fact that female mortality does not decrease with increasing income levels for smoking-related diseases, ischaemic heart disease and lung cancer. Thus, our results suggest that the decreasing female mortality advantage is mainly caused by increased smoking among women, while in the case of alcohol, violence and accidents the gender equalization seems to work in the opposite direction. In a nutshell, we conclude that the examination of the gender-specific mortality rates and mortality gaps without a disaggregation between different causes of death might mask important patterns of the epidemiological transition and the underlying drivers.mortality, gender differential, causes of death, life expectancy, Austria

Stronger sex but earlier death: A multi-level socioeconomic analysis of gender differences in mortality in Austria

Gender inequalities in mortality/life expectancy have been a major area of research in the social sciences since the 1970s. However, the questions posed and the research strategies used are still in a state of flux. In the present paper we shed some light on two related questions: (i) Which socioeconomic variables determine the gender gap in mortality? (ii) Are male and female mortality rates determined by different socioeconomic factors and in different shapes? We use aggregated data from Austria both at the community and district level covering the time period 1969 - 2004. Our two-level empirical design combined with a panel structure at the districts level reveals additional evidence on these questions compared to previous studies at the regional level. By using weighted regression analysis (panel fixed effects, pooled and cross section) we find that the gender gap is negatively associated with higher average net income, a higher educational level, a higher share of immigrants and better familial integration. In general, males are more sensitive with respect to social and economic conditions compared to females, leading to a narrowing gap in mortality when living conditions improve. These results are also confirmed by our Blinder-Oaxaca Decomposition.mortality, gender mortality gap, life expectancy, Austria

Entry and Exit of Physicians in a two-tiered public/private Health Care System

Firm turnover has recently attracted increased interest in economic research. The entry of new firms increases competition and promises efficiency gains. Moreover, changes in the market structure influence productivity growth, because firm entry usually leads to increased innovation. The health care market exhibits important differences as compared to other markets, including various forms of market failure and, as a consequence, extensive market regulation. Thus, the economic effects of entries and exits in health care markets are less obvious. The following paper studies the determinants of entry and exit decisions of physicians in the private sector of the outpatient part of the Austrian health care system. We apply a Poisson panel estimation to a data set of 2,379 local communities and 121 districts in Austria in the time period 2002 - 2008. We are particularly interested in the question how public physicians (GPs/specialists) and their private counterparts influence the entrance and exit of private physicians. We find a significantly negative effect of existing capacities, measured by both private and public physician density of the same specialty, on the entry of new private physicians. On the contrary, we find a significantly positive effect of private GPs on the entry of private specialists. Interestingly, this cooperation/network effect also works in the other direction, as a higher density of private specialists increases the probability of the market entry of private GPs. Based on the results of previous literature, we thus conclude that private physicians establish networks to cooperate in terms of mutual referrals etc. Our estimations for market exits basically confirm the entry results, as higher competitive forces positively influence the market exit of private physicians.Entry, Exit, Health Care, Physician location

Health status convergence at the local level: empirical evidence from Austria

<p>Abstract</p> <p>Introduction</p> <p>Health is an important dimension of welfare comparisons across individuals, regions and states. Particularly from a long-term perspective, within-country convergence of the health status has rarely been investigated by applying methods well established in other scientific fields. In the following paper we study the relation between initial levels of the health status and its improvement at the local community level in Austria in the time period 1969-2004.</p> <p>Methods</p> <p>We use age standardized mortality rates from 2381 Austrian communities as an indicator for the health status and analyze the convergence/divergence of overall mortality for (i) the whole population, (ii) females, (iii) males and (iv) the gender mortality gap. Convergence/Divergence is studied by applying different concepts of cross-regional inequality (weighted standard deviation, coefficient of variation, Theil-Coefficient of inequality). Various econometric techniques (weighted OLS, Quantile Regression, Kendall's Rank Concordance) are used to test for absolute and conditional beta-convergence in mortality.</p> <p>Results</p> <p>Regarding sigma-convergence, we find rather mixed results. While the weighted standard deviation indicates an increase in equality for all four variables, the picture appears less clear when correcting for the decreasing mean in the distribution. However, we find highly significant coefficients for absolute and conditional beta-convergence between the periods. While these results are confirmed by several robustness tests, we also find evidence for the existence of convergence clubs.</p> <p>Conclusions</p> <p>The highly significant beta-convergence across communities might be caused by (i) the efforts to harmonize and centralize the health policy at the federal level in Austria since the 1970s, (ii) the diminishing returns of the input factors in the health production function, which might lead to convergence, as the general conditions (e.g. income, education etc.) improve over time, and (iii) the mobility of people across regions, as people tend to move to regions/communities which exhibit more favorable living conditions.</p> <p><b>JEL classification: </b>I10, I12, I18</p

Health Status Convergence at the Local Level: Empirical Evidence from Austria

Health is an important dimension of welfare comparisons across individuals, regions or states. In the following paper we focus on the question whether the health status between geographical subunits (local communities) converged/diverged in the time period 1969 - 2004 in Austria. We use age standardized mortality rates as indicators for the health status and analyze the convergence/divergence of overall mortality for (i) the whole population, (ii) females, (iii) males and (iv) the gender gap in overall mortality. Convergence/Divergence is studied by applying different concepts of cross-regional inequality (weighted standard deviation, coefficient of variation, Theil-Coefficient of inequality). Various econometric techniques (weighted OLS, Quantile Regression, Kendall's Rank Concordance) are used to test for absolute and conditional beta-convergence in mortality. We find mixed results for the applied inequality measures. Absolute and conditional beta-convergence are confirmed, both in weighted OLS as well as in Quantile Regression estimations, but we also find strong evidence for the existence of convergence clubs in mortality in Austria.mortality, convergence, gender, health status, life expectancy, Austria

Convergence Without Hard Criteria: Does EU Soft Law Affect Domestic Unemployment Protection Schemes?

(VLID)177126