Are family physicians good for you? Endogenous doctor supply and individual health

Health Serv Res. 2008 Aug;43(4):1128-44. doi: 10.1111/j.1475-6773.2007.00823.x. Epub 2008 Jan 31.


Objective: To investigate the impact of family physician (FP) supply on individual health, adjusting for factors that affect both health and FPs' choice of location.

Study population: A total of 49,541 individuals in 351 English local authorities (LAs).

Data sources: Data on individual health and personal characteristics from three rounds (1998, 1999, and 2000) of the Health Survey for England were linked to LA data on FP supply.

Study design: Three methods for analyzing self-reported health were used. FP supply, instrumented by house prices and by age-weighted capitation payments for patients on FP lists, was included in individual-level health regressions along with individual and LA covariates.

Results: When no instruments are used FPs have a positive but statistically insignificant effect on health. When FP supply is instrumented by age-related capitation it has markedly larger and statistically significant effects. A 10 percent increase in FP supply increases the probability of reporting very good health by 6 percent.

Conclusion: After allowing for endogeneity, an increase in FP supply has a significant positive effect on self-reported individual health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • England
  • Female
  • Health Care Surveys
  • Health Expenditures
  • Health Services Accessibility / statistics & numerical data
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Office Visits / economics
  • Office Visits / statistics & numerical data*
  • Physician-Patient Relations*
  • Physicians, Family / economics
  • Physicians, Family / supply & distribution*
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / statistics & numerical data*