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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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    5. Costa-Font, Joan & Ferrer-i-Carbonell, Ada, 2017. "Can Regional Decentralisation Shift Health Care Preferences?," IZA Discussion Papers 11180, Institute of Labor Economics (IZA).
    6. World Bank & Oxford Policy Management, 2015. "Health Worker Survey in Timor-Leste," World Bank Publications - Reports 23879, The World Bank Group.
    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. 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.
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    14. 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.
    15. 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.
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    19. Ferreira, D.C. & Marques, R.C. & Nunes, A.M. & Figueira, J.R., 2018. "Patients’ satisfaction: The medical appointments valence in Portuguese public hospitals," Omega, Elsevier, vol. 80(C), pages 58-76.
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