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Generosity norms and intrinsic motivation in health care provision: evidence from the laboratory and the field

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Author Info

  • J. Michelle Brock

    ()
    (EBRD)

  • Andreas Lange

    (University of Hamburg)

  • Kenneth L. Leonard

    (University of Maryland)

Abstract

We examine the correlation between the generosity of clinicians – as measured in a laboratory experiment – and the quality of care in their normal practices under three different intrinsic incentive schemes. Specifically, we observe clinicians in their normal work environment, when a peer observes them and six weeks after an encouragement visit from a peer. Clinicians who give at least half of their endowment to a stranger in the laboratory (generous) provide 10 per cent better quality care than those who do not. In addition, the average clinician provides about 4 per cent better quality when observed by a peer and 10 per cent higher quality care after the encouragement visit. Importantly, we find that generous clinicians react to peer scrutiny and encouragement in the same way as non-generous clinicians. Many clinicians are intrinsically motivated to provide higher quality care. However, most clinicians respond to increased intrinsic incentives in the form of scrutiny and encouragement from peers.

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Bibliographic Info

Paper provided by European Bank for Reconstruction and Development, Office of the Chief Economist in its series Working Papers with number 147.

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Length: 27 pages
Date of creation: Aug 2012
Date of revision:
Publication status: Published in Working papers 147, European Bank for Reconstruction and Development
Handle: RePEc:ebd:wpaper:147

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Related research

Keywords: intrinsic incentives; health care quality; altruism; professionalism; Tanzania; experimental economics; Hawthorne effect; Encouragement effect; Study effect;

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References

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  1. Charness, Gary B & Rabin, Matthew, 2001. "Understanding Social Preferences With Simple Tests," University of California at Santa Barbara, Economics Working Paper Series qt0dc3k4m5, Department of Economics, UC Santa Barbara.
  2. Das, Jishnu & Hammer, Jeffrey & Leonard, Kenneth, 2008. "The quality of medical advice in low-income countries," Policy Research Working Paper Series 4501, The World Bank.
  3. Ellingsen, Tore & Johannesson, Magnus, 2006. "Pride and Prejudice: The Human Side of Incentive Theory," CEPR Discussion Papers 5768, C.E.P.R. Discussion Papers.
  4. Leonard, Kenneth L. & Masatu, Melkiory C., 2010. "Using the Hawthorne effect to examine the gap between a doctor's best possible practice and actual performance," Journal of Development Economics, Elsevier, vol. 93(2), pages 226-234, November.
  5. Mæstad, Ottar & Torsvik, Gaute, 2008. "Improving the quality of health care when health workers are in short supply," Working Papers in Economics 14/08, University of Bergen, Department of Economics.
  6. Josse Delfgaauw, 2007. "Dedicated Doctors: Public and Private Provision of Health Care with Altruistic Physicians," Tinbergen Institute Discussion Papers 07-010/1, Tinbergen Institute, revised 17 Sep 2007.
  7. Mæstad, Ottar & Torsvik, Gaute & Aakvik, Arild, 2010. "Overworked? On the relationship between workload and health worker performance," Journal of Health Economics, Elsevier, vol. 29(5), pages 686-698, September.
  8. Steven D. Levitt & John A. List, 2007. "What Do Laboratory Experiments Measuring Social Preferences Reveal About the Real World?," Journal of Economic Perspectives, American Economic Association, vol. 21(2), pages 153-174, Spring.
  9. Das, Jishnu & Hammer, Jeffrey, 2005. "Money for nothing : the dire straits of medical practice in Delhi, India," Policy Research Working Paper Series 3669, The World Bank.
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