The study examined the factors influencing the physician's decision to make these types of visits. Only 47 percent of sample physicians had made any nursing home visits during the previous week of practice, and 43 percent any house calls. Nursing home and house call visits constitute a secondary market for physician services, characterized by low 'pay,' poor working conditions and fewer opportunities for advancement. Physicians enter the market only when forced to do so by competition. As a result, physicians in the nursing home and house call markets were found to be less well trained on average than other physicians. In particular, they tended to be older, less specialized, and (in the case of nursing home visits) Third World medical school graduates. Although nursing home and house call reimbursement levels averaged as much or more as those for office visits, furthermore, they were apparently still too low to offset the high travel costs associated with making these two types of visits. Physicians were more likely to make nursing home visits and house calls when travel distances were shorter.
展开▼
