When incentives and professionalism collide
When incentives and professionalism collide
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DOI：
10.1377/hlthaff.27.4.949
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发表时间：
2008-07-01
期刊：
影响因子：
9.7
通讯作者：
Hsiao, William C.
中科院分区：
文献类型：
--
作者：
Hsiao, William C.
正如Jin Ma及其同事所观察到的那样，中国不受约束的市场方式减少了获得医疗服务的机会，增加了患者的经济负担，减少了对预防的重视，并可能导致质量和结果的下降。一个主要的驱动因素是，不正当的激励改变了医生的行为，使他们以牺牲病人为代价来追求自身利益，即使在职业道德要求相反的情况下也是如此。包括印度在内的其他国家正在努力应对利润动机及其后果。中国领导人正试图通过扩大公共投资和减少不当激励措施来解决这些问题。然而，在改革后的体制中，利润动机仍然是一个强大的、潜在的抵消性特征。
As Jin Ma and colleagues observe, an unfettered market approach in China has reduced access to care, increased patients' financial burden, and reduced emphasis on prevention and may have caused declines in quality and outcomes. A major driving force was that perverse incentives altered physicians' behavior toward self-interest at the expense of patients, even where professional ethics dictated otherwise. Other nations, including India, are grappling with the profit motive and its consequences. Chinese leaders are attempting to deal with these problems by expanding public investment and reducing perverse incentives. However, profit motives remain a powerful, potentially offsetting feature of a reformed system.