Applying an Extended Kernel Density 4-Step Floating Catchment Area method to identify priority districts to promote new publicly financed supply of gastroenterology exams

In continental Portugal, the publicly financed supply of gastroenterology exams, including endoscopies and colonoscopies, have been restricted since the end of the last century, with a fixed set of private providers being hired by the government to complement the limited public supply. This way of contracting creates market entry barriers and is inefficient, since prices are administratively set. Besides, it produces access inequities, because of the way that the supply is geographically distributed. This paper applies an Extended Kernel Density 4-Step Floating Catchment Area – EKD4SFCA method (Polzin et al., 2015) to identify priority districts for the promotion of new supply by the government, in order to reduce access inequities via public financing of private supply, and to choose the appropriate way of contracting, as determined by Decree-Law 139/2013. The EKD4SFCA method of Polzin et al. (2015), "A decision support method to identify target geographic markets for health care providers": accepted in January 2015 for publication in the journal Papers in Regional Science (ISSN: 1435-5957; IF: 1.183/5-Year IF: 1.629). The applied method enables the identification of the Portuguese regions with strong competition between health care providers and where patients' access to publicly financed gastroenterology exams is low. In these regions, the government should promote public bids to promote new supply, reducing thereby access inequities and exploring the potential for setting lower prices.