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Is patient satisfaction sensitive to changes in the quality of care? An exploitation of the Hawthorne effect

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  • Leonard, Kenneth L.

Abstract

We introduce a new instrument to evaluate the impact of behavior on outcomes when the behavior may be a function of unobserved variables that also affect outcomes. The instrument is introduced through a test of patient sensitivity to increases in the quality of care provided by doctors. We utilize the Hawthorne effect, in which the very presence of a research team causes doctors to provide measurably superior quality care for any type of patient to show that patients respond to this increased quality and are more likely to be very satisfied. Using the Hawthorne effect as an instrument allows us to examine the responsiveness of satisfaction to improvements in quality despite the fact that patient satisfaction is subjective and jointly produced with quality during the course of a consultation.

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  • Leonard, Kenneth L., 2008. "Is patient satisfaction sensitive to changes in the quality of care? An exploitation of the Hawthorne effect," Journal of Health Economics, Elsevier, vol. 27(2), pages 444-459, March.
  • Handle: RePEc:eee:jhecon:v:27:y:2008:i:2:p:444-459
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    References listed on IDEAS

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    Cited by:

    1. Simons, Andrew M. & Beltramo, Theresa & Blalock, Garrick & Levine, David I., 2017. "Using unobtrusive sensors to measure and minimize Hawthorne effects: Evidence from cookstoves," Journal of Environmental Economics and Management, Elsevier, vol. 86(C), pages 68-80.
    2. 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.
    3. Jishnu Das & Jeffrey Hammer & Kenneth Leonard, 2008. "The Quality of Medical Advice in Low-Income Countries," Journal of Economic Perspectives, American Economic Association, vol. 22(2), pages 93-114, Spring.
    4. Fuhai Hong & Tanjim Hossain & John List & Migiwa Tanaka, 2013. "Testing the Theory of Multitasking: Evidence from a Natural Field Experiment in Chinese Factories," Natural Field Experiments 00388, The Field Experiments Website.
    5. Pérotin, Virginie & Zamora, Bernarda & Reeves, Rachel & Bartlett, Will & Allen, Pauline, 2013. "Does hospital ownership affect patient experience? An investigation into public–private sector differences in England," Journal of Health Economics, Elsevier, vol. 32(3), pages 633-646.
    6. Costa-Font, Joan & Ferrer-i-Carbonell, Ada, 2017. "Can Regional Decentralisation Shift Health Care Preferences?," IZA Discussion Papers 11180, Institute for the Study of Labor (IZA).
    7. Gauthier, Bernard & Wane, Waly, 2011. "Bypassing health providers: The quest for better price and quality of health care in Chad," Social Science & Medicine, Elsevier, vol. 73(4), pages 540-549, August.
    8. Tracey, Marlon R. & Polachek, Solomon, 2017. "If Looks Could Heal: Child Health and Paternal Investment," IZA Discussion Papers 10866, Institute for the Study of Labor (IZA).
    9. Dunsch, Felipe A. & Evans, David K. & Eze-Ajoku, Ezinne & Macis, Mario, 2017. "Management, Supervision, and Health Care: A Field Experiment," IZA Discussion Papers 10967, Institute for the Study of Labor (IZA).
    10. Hansen, Fredrik & Anell, Anders & Gerdtham, Ulf-G & Lyttkens, Carl Hampus, 2013. "The Future of Health Economics: The Potential of Behavioral and Experimental Economics," Working Papers 2013:20, Lund University, Department of Economics.
    11. Glick, Peter, 2009. "How reliable are surveys of client satisfaction with healthcare services? Evidence from matched facility and household data in Madagascar," Social Science & Medicine, Elsevier, vol. 68(2), pages 368-379, January.

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