Sorting into payment schemes and medical treatment: A laboratory experiment
Sorting into payment schemes and medical treatment: A laboratory experiment
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DOI：
10.1002/hec.3616
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发表时间：
2017-12-01
期刊：
影响因子：
2.1
通讯作者：
Kokot, Johanna
中科院分区：
文献类型：
--
作者：
Brosig-Koch, Jeannette;Kairies-Schwarz, Nadja;Kokot, Johanna
在这项研究中，我们介绍了机会，医生分类到人头费或按服务付费。使用受控的医学框架实验室实验与序贯内的主题设计允许隔离排序的激励效果。我们观察到一个强烈的偏好收费服务支付，这并不取决于主题的先前经验与两个支付计划之一。此外，我们确定了一个显着的排序效果。选择按人头付费的受试者比选择按服务付费的受试者事先偏离患者最佳医疗方案的程度更小。特别是后者在引入选择选项后变得更不以患者为导向。因此，在按服务收费和按人头付费之间做出选择的机会，如果有的话，也会损害病人的治疗。我们的结果适用于医学和非医学学生。
In this study, we introduce the opportunity for physicians to sort into capitation or fee-for-service payment. Using a controlled medically framed laboratory experiment with a sequential within-subject design allows isolating sorting from incentive effects. We observe a strong preference for fee-for-service payment, which does not depend on subjects' prior experience with one of the two payment schemes. Further, we identify a significant sorting effect. Subjects choosing capitation deviate ex ante less from patient-optimal medical treatment than subjects who sort into fee-for-service payment. Particularly the latter become even less patient-oriented after introducing the choice option. Consequently, the opportunity to choose between fee-for-service and capitation payment worsens patient treatment, if at all. Our results hold for medical and for nonmedical students.