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What influences national and foreign physicians’ geographic distribution? An analysis of medical doctors’ residence location in Portugal

Overview of attention for article published in Human Resources for Health, July 2012
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  • Good Attention Score compared to outputs of the same age (68th percentile)

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6 tweeters


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48 Mendeley
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What influences national and foreign physicians’ geographic distribution? An analysis of medical doctors’ residence location in Portugal
Published in
Human Resources for Health, July 2012
DOI 10.1186/1478-4491-10-12
Pubmed ID

Giuliano Russo, Paulo Ferrinho, Bruno de Sousa, Cláudia Conceição


The debate over physicians' geographical distribution has attracted the attention of the economic and public health literature over the last forty years. Nonetheless, it is still to date unclear what influences physicians' location, and whether foreign physicians contribute to fill the geographical gaps left by national doctors in any given country. The present research sets out to investigate the current distribution of national and international physicians in Portugal, with the objective to understand its determinants and provide an evidence base for policy-makers to identify policies to influence it. A cross-sectional study of physicians currently registered in Portugal was conducted to describe the population and explore the association of physician residence patterns with relevant personal and municipality characteristics. Data from the Portuguese Medical Council on physicians' residence and characteristics were analysed, as well as data from the National Institute of Statistics on municipalities' population, living standards and health care network. Descriptive statistics, chi-square tests, negative binomial and logistic regression modelling were applied to determine: (a) municipality characteristics predicting Portuguese and International physicians' geographical distribution, and; (b) doctors' characteristics that could increase the odds of residing outside the country's metropolitan areas. There were 39,473 physicians in Portugal in 2008, 51.1% of whom male, and 40.2% between 41 and 55 years of age. They were predominantly Portuguese (90.5%), with Spanish, Brazilian and African nationalities also represented. Population, Population's Purchasing Power, Nurses per capita and Municipality Development Index (MDI) were the municipality characteristics displaying the strongest association with national physicians' location. For foreign physicians, the MDI was not statistically significant, while municipalities' foreign population applying for residence appeared to be an additional positive factor in their location decisions. In general, being foreigner and male resulted to be the physician characteristics increasing the odds of residing outside the metropolitan areas. However, among the internationals, older doctors were more likely to reside outside metropolitan areas. Being Spanish or Brazilian (but not of African origin) was found to increase the odds of being based outside the Lisbon and Oporto metropolitan areas. The present study showed the relevance of studying one country's physician population to understand the factors driving national and international doctors' location decisions. A more nuanced understanding of national and foreign doctors' location appears to be needed to design more effective policies to reduce the imbalance of medical services across geographical areas.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 2%
Spain 1 2%
Unknown 46 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 10 21%
Researcher 6 13%
Student > Bachelor 6 13%
Other 5 10%
Student > Doctoral Student 4 8%
Other 13 27%
Unknown 4 8%
Readers by discipline Count As %
Medicine and Dentistry 17 35%
Social Sciences 6 13%
Economics, Econometrics and Finance 5 10%
Unspecified 3 6%
Nursing and Health Professions 3 6%
Other 9 19%
Unknown 5 10%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 February 2013.
All research outputs
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Outputs from Human Resources for Health
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Outputs of similar age
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Outputs of similar age from Human Resources for Health
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Altmetric has tracked 21,334,388 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 1,096 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.6. This one is in the 35th percentile – i.e., 35% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 142,325 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them