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    <title>EconStor Collection: Ruhr Economic Papers, RWI</title>
    <link>http://hdl.handle.net/10419/15</link>
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      <title>How do non-monetary performance incentives for physicians affect the quality of medical care? A laboratory experiment</title>
      <link>http://hdl.handle.net/10419/73681</link>
      <description>Title: How do non-monetary performance incentives for physicians affect the quality of medical care? A laboratory experiment
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&lt;br/&gt;Authors: Kairies, Nadja; Krieger, Miriam
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&lt;br/&gt;Abstract: In recent years, several countries have introduced non-monetary performance incentives for health care providers to improve the quality of medical care. Evidence on the effect of non-monetary feedback incentives, predominantly in the form of public quality reporting, on the quality of medical care is, however, ambiguous. This is often because empirical research to date has not succeeded in distinguishing between the effects of monetary and non-monetary incentives, which are usually implemented simultaneously. We use a controlled laboratory experiment to isolate the impact of nonmonetary performance incentives: subjects take on the role of physicians and make treatment decisions for patients, receiving feedback on the quality of their treatment. The subjects' decisions result in payments to real patients. By giving either private or public feedback we are able to disentangle the motivational effects of self-esteem and social reputation. Our results reveal that public feedback incentives have a significant and positive effect on the quality of care that is provided. Private feedback, on the other hand, has no impact on treatment quality. These results hold for medical students and for other students.</description>
      <pubDate>Mon, 29 Oct 2012 22:58:59 GMT</pubDate>
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      <title>How to improve patient care? An analysis of capitation, fee-for-service, and mixed payment schemes for physicians</title>
      <link>http://hdl.handle.net/10419/73680</link>
      <description>Title: How to improve patient care? An analysis of capitation, fee-for-service, and mixed payment schemes for physicians
&lt;br/&gt;
&lt;br/&gt;Authors: Brosig-Koch, Jeannette; Hennig-Schmidt, Heike; Kairies, Nadja; Wiesen, Daniel
&lt;br/&gt;
&lt;br/&gt;Abstract: In recent health care reforms, several countries have replaced pure payment schemes for physicians (fee-for-service, capitation) by so-called mixed payment schemes. Until now it is still an unresolved issue whether patients are really better off after these reforms. In this study we compare the effects resulting from pure and mixed incentives for physicians under controlled laboratory conditions. Subjects in the role of physicians choose the quantity of medical services for different patient types. Real patients gain a monetary benefit from subjects' decisions. Our results reveal that overprovision observed in fee-for-service schemes and underprovision observed in capitation schemes can, in fact, be reduced by mixed incentives. Interestingly, even the presentation of pure incentives as mixed incentives already significantly affects physicians' behavior. Moreover, the mixed payment schemes generally provide a higher benefit-remuneration ratio than the respective pure payment schemes. Our findings provide some valuable insights for designing health care reforms.</description>
      <pubDate>Mon, 29 Oct 2012 22:58:59 GMT</pubDate>
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    <item>
      <title>Biting back at malaria: Self-medication, traditional healers, and the public sector</title>
      <link>http://hdl.handle.net/10419/73679</link>
      <description>Title: Biting back at malaria: Self-medication, traditional healers, and the public sector
&lt;br/&gt;
&lt;br/&gt;Authors: Paloyo, Alfredo R.; Reichert, Arndt R.
&lt;br/&gt;
&lt;br/&gt;Abstract: Malaria kills about 1,500 children every day. Based on the Demographic and Health Surveys, we examine malaria treatment practices of various health care providers in sub-Saharan Africa, where more than 90 percent of the world's deaths due to malaria occur. To assess the quality of each health care provider (including, among others, public health centers and traditional healers), we estimate the likelihood of providers to administer ineffective antimalarial drugs such as chloroquine in areas of known resistance, and to relieve children of malaria symptoms after having had fever within the last two weeks. Our results indicate that relative to self-medication, seeking treatment at most providers significantly increases the likelihood to take any antimalarial drug and decreases the likelihood to use chloroquine. Traditional healers do not exert any effect.</description>
      <pubDate>Mon, 29 Oct 2012 22:58:59 GMT</pubDate>
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    <item>
      <title>How effective are pay-for-performance incentives for physicians? A laboratory experiment</title>
      <link>http://hdl.handle.net/10419/73678</link>
      <description>Title: How effective are pay-for-performance incentives for physicians? A laboratory experiment
&lt;br/&gt;
&lt;br/&gt;Authors: Brosig-Koch, Jeannette; Hennig-Schmidt, Heike; Kairies, Nadja; Wiesen, Daniel
&lt;br/&gt;
&lt;br/&gt;Abstract: Recent reforms in health care have introduced a variety of pay-for-performance programs using financial incentives for physicians to improve the quality of care. Their effectiveness is, however, ambiguous as it is often difficult to disentangle the effect of financial incentives from the ones of various other simultaneous changes in the system. In this study we investigate the effects of introducing financial pay-for-performance incentives with the help of controlled laboratory experiments. In particular, we use fee-for-service and capitation as baseline payment schemes and test how additional pay-for-performance incentives affect the medical treatment of different patient types. Our results reveal that, on average, patients significantly benefit from introducing pay-forperformance, independently of hether it is combined with capitation or fee-for-service incentives. The magnitude of this effect is significantly influenced by the patient type, though. These results hold for medical and non-medical students. A cost-benefit analysis further demonstrates that, overall, the increase in patient benefits cannot overcompensate the additional costs associated with pay-for-performance. Moreover, our analysis of individual data reveals different types of responses to pay-for-performance incentives. We find some indication that pay-forperformance might crowd out the intrinsic motivation to care for patients. These insights help to understand the effects caused by introducing pay-for-performance schemes.</description>
      <pubDate>Mon, 29 Oct 2012 22:58:59 GMT</pubDate>
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