Summary of Aims and Objectives
Why is MABEL important?The decisions made by doctors on how many hours to work, where to work in terms of sector, location and specialty, and when to stop work temporarily or permanently, all have profound effects on the health system. This includes effects on access to health care, the capacity of the health care system to reduce burden of disease and to meet demand, and the quality of care provided to patients. Doctors' labour supply decisions are influenced by a complex mix of doctors' own preferences over work, leisure, family and lifestyle, the economic and non-economic incentives embedded in the way the health system is financed and organised, the culture of medical practice, and longer term trends in demand, demographic change, and the composition of the medical workforce.
The aim of this innovative research is to better understand the role and interplay of these factors through the analysis of the dynamics of the medical labour market in Australia. The research will achieve this by establishing a national longitudinal survey of the medical workforce. The significance of this research project includes:- A systematic and rigorous analysis of medical workforce decisions that underpin workforce distribution and the working patterns of doctors.
- The application of sophisticated methodologies not previously applied to health workforce research in Australia, such as Discrete Choice Experiments and microsimulation.
- Independent contribution to the evidence base that has a high potential for implementation to help resolve key health policy questions, namely how to best utilise the health workforce in the face of significant ongoing changes in both demand and supply.
- Development of capacity and new partnerships in health workforce research in Australia, through development and strengthening of collaborative relationships between policy makers and researchers in Australia's embryonic health workforce research community
- What is the impact of changes in economic incentives, including Medicare rebates and the level earnings, on labour supply decisions, working patterns and productivity?
- What is the impact of changes in family circumstances on labour supply decisions?
- How do the amenities and cost of living in different geographical areas influence decisions about where to work?
- What is the extent to which differences in job characteristics influence labour supply decisions?
- What is the relative importance of, and interaction between, the various determinants (1-4 above) of labour supply decisions?
- How does the effect of the above factors (1-4 above) vary across GPs, hospital doctors and private specialists, geographical areas, gender, and stages in the life and career cycle?
What are the key objectives of MABEL?
Objective 1. To describe and understand the determinants of trends in key measures of the labour supply of doctors The research using the survey will focus on a number of key questions. Each research question will be examined with respect to a number of key labour supply decisions: i) the choice of number of hours to work, ii) the balance between public or private sector work, iii) the location of work, iv) specialty choice, v) the balance between clinical and non-clinical work, vi) whether to take an absence to work overseas, have parental leave and return to work, and, vii) when to retire. These choices involve trade-offs made by doctors amongst the costs and benefits associated with each type of decision. It is the costs and benefits of these decisions that can be influenced by policy and that are the focus of the research questions below.
Objective 2. To use a microsimulation model to evaluate and predict the effect of workforce on measures of doctors' labour supply. A key aspect of the research will be the microsimulation of the effects of policy changes on labour supply. This will simulate the effect of changes in earnings, taxes, Medicare rebates, job satisfaction, and modifiable job characteristics on key measures of labour supply for the whole population of doctors, providing a valuable resource for national and state workforce planning. The microsimulation will be conducted using the Melbourne Institute Tax and Transfer Simulator (MITTS) which has been developed to examine the labour supply responses of the working age population to changes in their wages and to changes in taxes and welfare payments. The survey will provide convenient data that can be used to evaluate the costs and effects of actual large-scale policy changes in between each wave of the survey. This will provide an opportunity to compare predictions of the model with actual outcomes.
Objective 3. To build long-term health services research capacity around the ALSD.
There is currently little health services research capacity focused on researching the health workforce. This project will combine the skills of epidemiology, health economics and labour economics to produce researchers with expertise in health workforce research. The survey will be used as a platform around which research capacity can be built.