Physicians' responses to financial and social incentives: A medically framed real effort experiment

2017
Because compensation policies have critical implications for the provision of health care, and evidence of their effects is limited and difficult to study in the real world, laboratory experiments may be a valuable methodology to study the behavioural responses of health care providers. With this experiment undertaken in 2013, we add to this new literature by designing a new medically framed real effort task to test the effects of different remuneration schemes in a multi-tasking context. We assess the impact of different incentives on the quantity (productivity) and quality of outputs of 132 participants. We also test whether the existence of benefits to patients influences effort. The results show that salary yields the lowest quantity of output, and fee-for-service the highest. By contrast, we find that the highest quality is achieved when participants are paid by salary, followed by capitation. We also find a lot of heterogeneity in behaviour, with intrinsically motivated individuals hardly sensitive to financial incentives. Finally, we find that when work quality benefits patients directly, subjects improve the quality of their output, while maintaining the same levels of productivity. This paper adds to a nascent literature by providing a new approach to studying remuneration schemes and modelling the medical decision making environment in the lab. (C) 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
SOCIAL SCIENCE & MEDICINE
页码:147-159|卷号:179
ISSN:0277-9536
收录类型
SSCI
发表日期
2017
学科领域
循证公共卫生
国家
英国
语种
英语
DOI
10.1016/j.socscimed.2017.03.002
其他关键词
PERFORMANCE PAY; PAYMENT SYSTEMS; PRODUCTIVITY; PREFERENCES; BEHAVIOR; COMPETITION; MOTIVATION; PROVISION; QUALITY; NURSES
EISSN
1873-5347
资助机构
UK Aid from the UK Department for International Development (DFID)
资助信息
This manuscript is an output from a project funded by the UK Aid from the UK Department for International Development (DFID) for the benefit of developing countries. However, the views expressed and information contained in it are not necessarily those of or endorsed by DFID, which can accept no responsibility for such views or information or for any reliance placed on them.
被引频次(WOS)
22
被引更新日期
2022-01
来源机构
University of London London School Economics & Political Science University of Witwatersrand
关键词
South Africa Real effort experiment Fee-for-service Capitation Salary Altruism