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市场是否重视医患关系中的种族和民族一致性?

Does the market value racial and ethnic concordance in physician-patient relationships?

作者信息

Brown Timothy T, Scheffler Richard M, Tom Sarah E, Schulman Kevin A

机构信息

Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, School of Public Health, University of California, 140 Earl Warren Hall, MC7360, Berkeley, CA 94720-7360, USA.

出版信息

Health Serv Res. 2007 Apr;42(2):706-26. doi: 10.1111/j.1475-6773.2006.00634.x.

Abstract

OBJECTIVE

To determine if the market-determined earnings per hour of physicians is sensitive to the degree of area-level racial/ethnic concordance (ALREC) in the local physician labor market.

DATA SOURCES

1998-1999 and 2000-2001 Community Tracking Study Physician Surveys and Household Surveys, 2000 U.S. Census, and the Area Resource File.

STUDY DESIGN

Population-averaged regression models with area-level fixed effects were used to estimate the determinants of log earnings per hour for physicians in a two-period panel (N=12,886). ALREC for a given racial/ethnic group is measured as the percentage of physicians who are of a given race/ethnicity less the percentage of the population who are of the corresponding race/ethnicity. Relevant control variables were included.

PRINCIPAL FINDINGS

Average earnings per hour for Hispanic and Asian physicians varies with the degree of ALREC that corresponds to a physician's race/ethnicity. Both Hispanic and Asian physicians earn more per hour in areas where corresponding ALREC is negative, other things equal. ALREC varies from negative to positive for all groups. ALREC for Hispanics is negative, on average, due to the small percentage of the physician workforce that is Hispanic. This results in an average 5.6 percent earnings-per-hour premium for Hispanic physicians. However, ALREC for Asians is positive, on average, due to the large percentage of the physician workforce that is Asian. This results in an average 4.0 percent earnings-per-hour discount for Asian physicians. No similar statistically significant results were found for black physicians.

CONCLUSIONS

The market-determined earnings per hour of Hispanic and Asian physicians are sensitive to the degree of ALREC in the local labor market. Larger sample sizes may be needed to find statistically significant results for black physicians.

摘要

目的

确定由市场决定的医生每小时收入是否会受到当地医生劳动力市场中地区层面种族/民族一致性(ALREC)程度的影响。

数据来源

1998 - 1999年和2000 - 2001年社区追踪研究医生调查与家庭调查、2000年美国人口普查以及地区资源文件。

研究设计

采用具有地区层面固定效应的总体平均回归模型,对两期面板中的医生每小时对数收入的决定因素进行估计(N = 12,886)。给定种族/民族群体的ALREC衡量的是某一特定种族/民族的医生占比减去相应种族/民族的人口占比。纳入了相关控制变量。

主要发现

西班牙裔和亚裔医生的平均每小时收入随与医生种族/民族相对应的ALREC程度而变化。在其他条件相同的情况下,西班牙裔和亚裔医生在相应ALREC为负的地区每小时收入更高。所有群体的ALREC从负到正变化。西班牙裔的ALREC平均为负,因为西班牙裔医生劳动力占比小。这使得西班牙裔医生平均每小时收入溢价5.6%。然而,亚裔的ALREC平均为正,因为亚裔医生劳动力占比大。这导致亚裔医生平均每小时收入折扣4.0%。未发现黑人医生有类似的统计学显著结果。

结论

市场决定的西班牙裔和亚裔医生每小时收入对当地劳动力市场中ALREC的程度敏感。可能需要更大的样本量才能发现黑人医生的统计学显著结果。

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