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http://hdl.handle.net/11375/29027
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DC Field | Value | Language |
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dc.contributor.advisor | Sweetman, Arthur | - |
dc.contributor.author | Islam, Rabiul | - |
dc.date.accessioned | 2023-10-12T15:55:48Z | - |
dc.date.available | 2023-10-12T15:55:48Z | - |
dc.date.issued | 2023 | - |
dc.identifier.uri | http://hdl.handle.net/11375/29027 | - |
dc.description.abstract | Despite Canada's record-high physician-to-population ratio, persistent wait times for specialist healthcare and insufficient primary healthcare access raise questions. Why does Canada face medical service shortages notwithstanding its high physician count per capita? What factors should be accounted for in physician workforce planning? To address these questions, I analyze Statistics Canada's population estimates and Labour Force Survey (LFS), and the Canadian Institute for Health Information's (CIHI's) physician expenditure and socio-demographic data, from 1987 to 2021. I focus predominantly on the supply side but also consider the demand side. In the first paper, I show that despite a 35% increase in physicians per capita from 1987 to 2019, the growth rate adjusted for physician labour supply and population aging is negative four percentage points. A 20% reduction in physician work hours from 1987 to 2020 contributes to this decline. These findings underscore the importance of considering factors beyond physician counts. In the second paper, examining physicians' COVID-19 responses, I find a statistically significant reduction in work hours during the first wave, with a subsequent recovery to the pre-pandemic level. The net reduction was entirely in community settings, with no statistically significant difference between general practitioners/family physicians and specialists. Moreover, no statistically significant gender differences were observed. In the third paper, I investigate factors contributing to the declining physician work hours using the LFS– a general-purpose survey. As the LFS survey weights are not designed for physician-specific analysis, I apply a generalized method of moments (GMM) weighting technique using CIHI's physician population data that improves estimation quality. This illustrates how the bias and/or precision of general-purpose surveys can be improved in profession-specific analyses. Reduced hours among males, the increased share of females, workforce aging, and an increase in absence rates and lengths are key reasons behind the decline. | en_US |
dc.language.iso | en | en_US |
dc.subject | Healthcare | en_US |
dc.subject | Physician Labour Supply | en_US |
dc.subject | Physician Shortage | en_US |
dc.subject | Work Hours | en_US |
dc.subject | Aging Workforce | en_US |
dc.subject | Birth Cohorts | en_US |
dc.title | Three Papers on Physician Labour Supply in Canada | en_US |
dc.type | Thesis | en_US |
dc.contributor.department | Economics | en_US |
dc.description.degreetype | Dissertation | en_US |
dc.description.degree | Doctor of Philosophy (PhD) | en_US |
dc.description.layabstract | Despite the record-high number of physicians per person, Canadians are experiencing shortages of physicians, which are reflected in long wait times for specialist services and inadequate access to primary care. In this thesis, I use supply and demand data to investigate the reasons for shortages. Analyzing data from 1987 to 2021, I find that although physicians per person grew significantly, the adjusted growth is negative due to physicians' reduced work hours and population aging. Average work hours decreased mainly because of reduced hours by males and an increasing share of females who usually work fewer hours than their male counterparts. Investigating data during COVID-19, I find that physicians worked reduced hours during the pandemic's first wave and then resumed regular hours. No gender gap is observed in the reduced hours, but a gap is evident across practice settings, with the hours reduction occurring entirely among those practicing in the community. | en_US |
Appears in Collections: | Open Access Dissertations and Theses |
Files in This Item:
File | Description | Size | Format | |
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Islam_Rabiul_September2023_Ph.D..pdf | 1.88 MB | Adobe PDF | View/Open |
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