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Supply and Demand of Medical Services in Northwest South Dakota: an Economic Analysis L

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Supply and Demand of Medical Services in Northwest South Dakota: an Economic Analysis L South Dakota State University Open PRAIRIE: Open Public Research Access Institutional Repository and Information Exchange South Dakota State University Agricultural Bulletins Experiment Station 3-1-1970 Supply and Demand of Medical Services in Northwest South Dakota: An Economic Analysis L. G. Bierman M. J. Powers Follow this and additional works at: http://openprairie.sdstate.edu/agexperimentsta_bulletins Recommended Citation Bierman, L. G. and Powers, M. J., "Supply and Demand of Medical Services in Northwest South Dakota: An Economic Analysis" (1970). Bulletins. Paper 571. http://openprairie.sdstate.edu/agexperimentsta_bulletins/571 This Bulletin is brought to you for free and open access by the South Dakota State University Agricultural Experiment Station at Open PRAIRIE: Open Public Research Access Institutional Repository and Information Exchange. It has been accepted for inclusion in Bulletins by an authorized administrator of Open PRAIRIE: Open Public Research Access Institutional Repository and Information Exchange. For more information, please contact [email protected]. Bulletin 568 March 1970 In Northwest South Dakota Supply and Demand of Medical Services An Economic Analysis Economics Department Agricultural Experiment Station South Dakota State University, Brookings Supply and Demand of Medical Services In Northwest South Dakota An Economic Analysis By Mark J. Powers, associate professor Leland G. Bierman, graduate assistant Economics Department Agricultural Experiment Station South Dakota State University, Brookings CONTENTS PART I Introd u ction ------------------------------------------------------------------------------------------ 5 Description of Area ------------------------------------------------------------------------------ 6 Demogra phics of Study Area ------------------------------------------------------------ 7 Economic Characteristics ---------------------------------------------------------------------- l O Growth in Demand for Medical Care ------------------------------------------------ 13 Growth of Outpatient Facilities ------------------------------------------------------ 13 Growth of Inpatient Care -------------------------------------------------------------- 14 Implications for the Future Demand -------------------------------------------------- 15 PART II Supply of Medical and Health Resources in Area---------------------------- 16 Medical Manpower Available ------------------------------------------------------------ 16 Doctors ________________-------------------------------------- ------------------------------------------ 16 Dentists and Opto met ris ts---------------------------------------------------------------- 19 Hospi taI Personne I ----------------------------'----------------------------------------------- 20 Relationship of Personnel Available to Hospital Size---------------------- 20 Area's Dependence Upon Part-time Personnel_ _________________________________ 21 Amount of Care Provided by Hospitals-------------------------------------------- 23 Use Rate of Available Hospitals -------------------------------------------------------- 23 Differences in Type of Care Given------------------------------------------------------ 25 Distance Traveled for Out-of-Town Care------------------------------------------ 26 Geographic Loco tions -------------------------------------------------------------------------- 28 Con cI usions and ImpIi cations -------------------------------------------------------------- 28 Summary -------------------------------------------------------------------------------------------- 29 Figure 1. Population Density of Counties, 1967 -------------------------------- 7 Figure 2. Location of Dentists and Optometrists, 1969 ____________________ 20 4 PART I A community which has its own Because of rising costs, person­ hospital and doctor is benefited in nel shortages, and rapidly advanc­ many ways. First, people in the ing medical technology, communi­ community are near medical care ties throughout the United States in times of emergency. Second, hos­ are having difficulty providing the pital patients from the community types of medical services required are near family and friends when today. receiving care. Third, a community Rural areas are particularly hard may be benefited economically by hit by rising costs and medical per­ the presence of a hospital facility sonnel shortages because they have because additional jobs are provid­ the additional problem of low popu­ ed and people from the surrounding lation density. These communities area are given increased incentive often find that the population base to come to the town in purchasing of relatively large hospital service other goods. Also, adequate medi­ areas is not large enough to suppport cal services are of importance in at­ a hospital of sufficient size to pro­ tracting new industry into a town. vide the types of facilities doctors The trend today, however, is a­ need in treating patients. As a re­ way from the concept of the small sult, communities constructing hospital and one doctor for each small hospitals frequently have dif­ town. The modern practice of med­ ficulty holding a physician for any icine requires specialization of length of time. equipment and personnel to a de­ In summary, the situation is this: gree not practical in many small modern medicine, with its emphasis town situations. upon specialization of personnel 5 and equipment, is forcing many Northwest South Dakota is an small towns to lose both doctor and area of diverse characteristics. It in­ hospital. In sparsely populated cludes an urban area as well. as areas where the distance between sparsely populated areas; pockets of major trade centers is considerable, poverty and the largest gold mine in this trend away from small town North America. medical facilities often denies many people ready access to medical Most of the area is rural and suit­ able mainly for farming and ranch­ services. The problem, then, be­ ing. Most industry is of the light comes one of providing easy access manufacturing or fabricating na­ to medical services for people locat­ ture, although two large employers ed in sparsely populated areas in South Dakota. in the area are the Homestake Min­ ing Company and the Ellsworth Air The purpose of this publication is Force Base, both near Rapid City. to give a general description of the Recreation and tourism is a major problems facing the Northwest industry in the area as the Black South Dakota area in providing Hills, on the west, and the Missouri medical and health services and to River to the east, are favorite vaca­ analyze some of the factors affect­ tion spots for South Dakotans and ing the future demand for such serv­ many other Americans. ices and the supply of resources About one-sixth of the land area available for meeting that demand. is devoted to Indian Reservations. With this information, policy mak­ The Indian population is served by ers and rural community leaders will two Public Health Hospitals, nei­ have a better basis for making rele­ ther open to the general public, vant decisions on the coordination hence not included in this study. of health services within their area to provide accessibility to health In general, Northwest South Da­ services at the least possible cost, kota is characterized by a concen­ consistent with desired quality tration of population at opposite standards. ends of the area, near the Black Hills and near the Missouri River, The first part of this publication with a vast space between devoted will discuss some geographic, demo­ almost exclusively to farming and graphic, and economic factors of ranching and containing nearly half the area and the effect they have on of the population. These character­ the demand for medical and health istics present problems in providing services. The second part will deal easy access to medical and health with the supply of medical and care for all the people in the area. health resources available in the area. Demographics of Study Area In 1967 the average population Description of Area 1 Northwest South Dakota is defined for pur­ The area designated as Northwest poses of this study as encompassing the fol­ South Dakota is composed of 16 lowing counties: Harding, Butte, Lawrence, counties.1 It is approximately 120 Pennington, Perkins, Meade, Corson, Ziebach, Haako:1, Dewey, Stanley, Campbell, Wal­ miles wide and 160 miles long. worth, Potter, Sully, Hughes. 6 Figure 1. Population density of counties in northwest South Dakota, 1967. Campbell Harding Perkins A Corson • (3,300) (2,000)• (5,200) (6,000) • • • Dewey • • (5,100) • Butte Potter (8,400) • (5,200). • Ziebach (2,200) Meade 0 • (19,900) Haakon Stanley (1,815) (1,483) KEY TO FIGURE Population Size of Towns, 1960 , County Populations, 1967 e 400-999 [ill 11 or more people per square mile • 1,000-2,499 � 6-10.9 people per square mile (no � area represented) 0 2,500-4,999 less than 6 people per square mile • above 5,000 D ( ) Total population in county density for Northwest South Dakota relatively slow rate ( see table 1). Al­ was approximately six people per though total population in North­ square mile. Counties in the area west South Dakota has been increas­ ranged from an average of 21.8 ing, the increases have occurred in people per square mile in Lawrence very selective areas. Only 5 out of County to 0.7 people per square the 16 counties registered an in­ mile in Harding County ( see figure crease in population between 1960 1 and table 1). The location of
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