Improving the quality of health care when health workers are in short supply
AbstractA number of low- and middle-income countries have a severe shortage of health workers. This paper studies how health workers’ choices of labour supply and work effort impact on the quality of health services when health workers are in short supply. We analyse how policy measures such as monetary incentives, monitoring, provisions of quality-enhancing inputs, and the building of professionalism and organisational identity can improve the quality of health care in the presence of a health worker shortage. We find that to pay health workers based on the number of patients may have a positive impact on the quality of health care even if quality does not affect demand. Furthermore, provision of quality-enhancing drugs and equipment may reduce health workers’ effort in delivering quality care, thus diminishing the positive impact of such interventions. Our most surprising result is that if the actual quality of health care is far below a professional standard, measures to build a professional mindset among health workers may reduce the quality of care.
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Bibliographic InfoPaper provided by University of Bergen, Department of Economics in its series Working Papers in Economics with number 14/08.
Length: 25 pages
Date of creation: 02 Jul 2008
Date of revision:
Contact details of provider:
Postal: Institutt for økonomi, Universitetet i Bergen, Postboks 7802, 5020 Bergen, Norway
Web page: http://www.uib.no/econ/en
More information through EDIRC
Public Goods; Laboratory; Individual Behavior;
Other versions of this item:
- Ottar Mæstad & Gaute Torsvik, 2008. "Improving the Quality of Health Care when Health Workers are in Short Supply," CMI Working Papers 12, CMI (Chr. Michelsen Institute), Bergen, Norway.
- C91 - Mathematical and Quantitative Methods - - Design of Experiments - - - Laboratory, Individual Behavior
- H41 - Public Economics - - Publicly Provided Goods - - - Public Goods
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- Kenneth L. Leonard & Melkiory C. Masatu & Alexandre Vialou, 2007. "Getting Doctors to Do Their Best: The Roles of Ability and Motivation in Health Care Quality," Journal of Human Resources, University of Wisconsin Press, vol. 42(3).
- George A. Akerlof & Rachel E. Kranton, 2005. "Identity and the Economics of Organizations," Journal of Economic Perspectives, American Economic Association, vol. 19(1), pages 9-32, Winter.
- Das, Jishnu & Hammer, Jeffrey, 2007.
"Money for nothing: The dire straits of medical practice in Delhi, India,"
Journal of Development Economics,
Elsevier, vol. 83(1), pages 1-36, May.
- 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.
- Ching-to Albert Ma & Thomas G. McGuire, 1995.
"Optimal Health Insurance and Provider Payment,"
0059, Boston University - Industry Studies Programme.
- Martin Gaynor & James B. Rebitzer & Lowell J. Taylor, 2004. "Physician Incentives in Health Maintenance Organizations," Journal of Political Economy, University of Chicago Press, vol. 112(4), pages 915-931, August.
- Woodward, Robert S. & Warren-Boulton, Frederick, 1984. "Considering the effects of financial incentives and professional ethics on `appropriate' medical care," Journal of Health Economics, Elsevier, vol. 3(3), pages 223-237, December.
- Tore Ellingsen & Magnus Johannesson, 2007. "Paying Respect," Journal of Economic Perspectives, American Economic Association, vol. 21(4), pages 135-150, Fall.
- Nazmul Chaudhury & Jeffrey Hammer & Michael Kremer & Karthik Muralidharan & F. Halsey Rogers, 2006. "Missing in Action: Teacher and Health Worker Absence in Developing Countries," Journal of Economic Perspectives, American Economic Association, vol. 20(1), pages 91-116, Winter.
- Ma, Ching-to Albert, 1994.
"Health Care Payment Systems: Cost and Quality Incentives,"
Journal of Economics & Management Strategy,
Wiley Blackwell, vol. 3(1), pages 93-112, Spring.
- Ching-to Albert Ma, 1994. "Health Care Payment Systems: Cost and Quality Incentives," Papers 0047, Boston University - Industry Studies Programme.
- Abhijit Banerjee & Esther Duflo, 2006. "Addressing Absence," Journal of Economic Perspectives, American Economic Association, vol. 20(1), pages 117-132, Winter.
- Leonard, Kenneth L. & Masatu, Melkiory C., 2008. "Professionalism, Latent Professionalism and Organizational Demands for Health Care Quality in a Developing Country," Working Papers 42883, University of Maryland, Department of Agricultural and Resource Economics.
- 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.
- Leonard, Kenneth L. & Masatu, Melkiory C., 2008. "Using the Hawthorne Effect to Examine the Gap Between a Doctor's Best Possible Practice and Actual Performance," Working Papers 36693, University of Maryland, Department of Agricultural and Resource Economics.
- J. Michelle Brock & Andreas Lange & Kenneth L. Leonard, 2012. "Generosity norms and intrinsic motivation in health care provision: evidence from the laboratory and the field," Working Papers 147, European Bank for Reconstruction and Development, Office of the Chief Economist.
- J. Michelle Brock & Andreas Lange & Kenneth L. Leonard, 2014. "Giving and promising gifts: experimental evidence on reciprocity from the field," Working Papers 165, European Bank for Reconstruction and Development, Office of the Chief Economist.
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