支付方案选择与医疗处理:一项实验室实验

Sorting into payment schemes and medical treatment: A laboratory experiment

Health Economics · 2017
被引 16
人大 A-

中文导读

通过实验室实验,研究医生在按人头付费和按服务收费之间选择的机会如何影响医疗决策,发现医生偏好按服务收费,且选择权可能恶化患者治疗。

Abstract

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.

按绩效付费按人头付费医生自选择医疗服务质量