The effect of HMO penetration on physician retirement.

P. R. Kletke, Daniel E. Polsky, G. D. Wozniak, J. J. Escarce

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To examine the effect of HMO penetration on physician retirement. STUDY DESIGN: We linked together historical data from the Physician Masterfile of the American Medical Association for successive years to track changes in physicians' activity status between 1980 and 1997. We used a multivariate discrete-time survival model to examine how the probability of physician retirement was affected by the level of HMO penetration in the physician's market area, controlling for other physician and market characteristics. The study population included all active allopathic patient-care physicians in the United States who reached age 55 between the years of 1980 and 1996. The main outcome measure was physician retirements as reported on the Physician Masterfile. PRINCIPAL FINDINGS: HMO penetration had a statistically significant positive effect on the retirement probabilities of generalists and medical/surgical specialists, but it s effect on hospital-based specialists and psychiatrists was not significant . For generalists regression-adjusted retirement probabilities were roughly 13 percent greater in high-penetration markets (HMO penetration of 45 percent ) than in low-penetration markets (HMO penetration of 5 percent ). For medical/surgical specialist s regression-adjusted retirement probabilities were roughly 17 percent greater in high-penetration markets than in low-penetration markets. CONCLUSIONS: Our findings suggest that many older physicians have found it preferable to retire rather than adapt their practices to an environment with a high degree of managed care penetration . Because the number of physicians entering the older age categories will increase rapidly over the next 20 years, the growth of managed care and other influences on physician retirement will play an increasingly important role in determining the size of the physician workforce.

Original languageEnglish (US)
Pages (from-to)17-31
Number of pages15
JournalHealth services research
Volume35
Issue number5 Pt 3
StatePublished - Jan 1 2000
Externally publishedYes

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Health Maintenance Organizations
Retirement
Physicians
Managed Care Programs
American Medical Association
Psychiatry
Patient Care

ASJC Scopus subject areas

  • Health Policy

Cite this

Kletke, P. R., Polsky, D. E., Wozniak, G. D., & Escarce, J. J. (2000). The effect of HMO penetration on physician retirement. Health services research, 35(5 Pt 3), 17-31.

The effect of HMO penetration on physician retirement. / Kletke, P. R.; Polsky, Daniel E.; Wozniak, G. D.; Escarce, J. J.

In: Health services research, Vol. 35, No. 5 Pt 3, 01.01.2000, p. 17-31.

Research output: Contribution to journalArticle

Kletke, PR, Polsky, DE, Wozniak, GD & Escarce, JJ 2000, 'The effect of HMO penetration on physician retirement.', Health services research, vol. 35, no. 5 Pt 3, pp. 17-31.
Kletke PR, Polsky DE, Wozniak GD, Escarce JJ. The effect of HMO penetration on physician retirement. Health services research. 2000 Jan 1;35(5 Pt 3):17-31.
Kletke, P. R. ; Polsky, Daniel E. ; Wozniak, G. D. ; Escarce, J. J. / The effect of HMO penetration on physician retirement. In: Health services research. 2000 ; Vol. 35, No. 5 Pt 3. pp. 17-31.
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