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Does performance disclosure influence physicians’ medical decisions? An experimental study

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  • Godager, Geir

    () (Department of Health Management and Health Economics)

  • Hennig-Schmidt, Heike

    (Department of Health Management and Health Economics)

  • Iversen, Tor

    (Department of Health Management and Health Economics)

Abstract

Quality improvements in markets for medical care are key objectives in any Health reform. An important question is whether disclosing physicians’ performance can contribute to achieving these goals. Due to the asymmetric information inherent in medical markets, one may argue that changes in the information structure are likely to influence the environment in which health care providers operate. In a Laboratory experiment with medical students that mimics a physician decision-making environment we analyze the effect of disclosing performance information to peers. We find that making performance transparent has a positive impact in that significantly higher total patient benefits are generated than under a regime where physician performance is private information. Also, significantly more patients receive benefit-maximizing treatment. We discuss policy implications of our findings

Suggested Citation

  • Godager, Geir & Hennig-Schmidt, Heike & Iversen, Tor, 2014. "Does performance disclosure influence physicians’ medical decisions? An experimental study," HERO Online Working Paper Series 2014:4, University of Oslo, Health Economics Research Programme.
  • Handle: RePEc:hhs:oslohe:2014_004
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    References listed on IDEAS

    as
    1. Chalkley, Martin & Malcomson, James M., 1998. "Contracting for health services when patient demand does not reflect quality," Journal of Health Economics, Elsevier, vol. 17(1), pages 1-19, January.
    2. Fehr, Ernst & Falk, Armin, 2002. "Psychological foundations of incentives," European Economic Review, Elsevier, vol. 46(4-5), pages 687-724, May.
    3. Kesternich, Iris & Schumacher, Heiner & Winter, Joachim, 2015. "Professional norms and physician behavior: Homo oeconomicus or homo hippocraticus?," Journal of Public Economics, Elsevier, vol. 131(C), pages 1-11.
    4. Hennig-Schmidt, Heike & Selten, Reinhard & Wiesen, Daniel, 2011. "How payment systems affect physicians' provision behaviour--An experimental investigation," Journal of Health Economics, Elsevier, vol. 30(4), pages 637-646, July.
    5. Godager, Geir & Hennig-Schmidt, Heike & Iversen, Tor, 2016. "Does performance disclosure influence physicians’ medical decisions? An experimental study," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 36-46.
    6. repec:zbw:rwirep:0414 is not listed on IDEAS
    7. Jeannette Brosig‐Koch & Heike Hennig‐Schmidt & Nadja Kairies‐Schwarz & Daniel Wiesen, 2017. "The Effects of Introducing Mixed Payment Systems for Physicians: Experimental Evidence," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 243-262, February.
    8. Alwine Mohnen & Kathrin Pokorny & Dirk Sliwka, 2008. "Transparency, Inequity Aversion, and the Dynamics of Peer Pressure in Teams: Theory and Evidence," Journal of Labor Economics, University of Chicago Press, vol. 26(4), pages 693-720, October.
    9. Armin Falk & James J. Heckman, 2009. "Lab Experiments are a Major Source of Knowledge in the Social Sciences," Working Papers 200935, Geary Institute, University College Dublin.
    10. Dirk Engelmann & Martin Strobel, 2007. "Preferences over Income Distributions," Public Finance Review, , vol. 35(2), pages 285-310, March.
    11. Davis, Douglas D. & Holt, Charles a., 1993. "Experimental economics: Methods, problems and promise," Estudios Económicos, El Colegio de México, Centro de Estudios Económicos, vol. 8(2), pages 179-212.
    12. Jean Tirole & Roland Bénabou, 2006. "Incentives and Prosocial Behavior," American Economic Review, American Economic Association, vol. 96(5), pages 1652-1678, December.
    13. Glenn W. Harrison & John A. List, 2004. "Field Experiments," Journal of Economic Literature, American Economic Association, vol. 42(4), pages 1009-1055, December.
    14. Harbaugh, William T, 1998. "The Prestige Motive for Making Charitable Transfers," American Economic Review, American Economic Association, vol. 88(2), pages 277-282, May.
    15. Godager, Geir & Wiesen, Daniel, 2013. "Profit or patients’ health benefit? Exploring the heterogeneity in physician altruism," Journal of Health Economics, Elsevier, vol. 32(6), pages 1105-1116.
    16. Glenn W. Harrison & Morten I. Lau & E. Elisabet Rutström, 2007. "Estimating Risk Attitudes in Denmark: A Field Experiment," Scandinavian Journal of Economics, Wiley Blackwell, vol. 109(2), pages 341-368, June.
    17. Andreoni, James & Petrie, Ragan, 2004. "Public goods experiments without confidentiality: a glimpse into fund-raising," Journal of Public Economics, Elsevier, vol. 88(7-8), pages 1605-1623, July.
    18. Armin Falk & James J. Heckman, 2009. "Lab Experiments are a Major Source of Knowledge in the Social Sciences," CESifo Working Paper Series 2894, CESifo Group Munich.
    19. Krupka, Erin & Weber, Roberto A., 2009. "The focusing and informational effects of norms on pro-social behavior," Journal of Economic Psychology, Elsevier, vol. 30(3), pages 307-320, June.
    20. Godager, Geir & Iversen, Tor & Ma, Ching-to Albert, 2015. "Competition, gatekeeping, and health care access," Journal of Health Economics, Elsevier, vol. 39(C), pages 159-170.
    21. Jack, William, 2005. "Purchasing health care services from providers with unknown altruism," Journal of Health Economics, Elsevier, vol. 24(1), pages 73-93, January.
    22. Soetevent, Adriaan R., 2005. "Anonymity in giving in a natural context--a field experiment in 30 churches," Journal of Public Economics, Elsevier, vol. 89(11-12), pages 2301-2323, December.
    23. Arthur Schram & Gary Charness, 2015. "Inducing Social Norms in Laboratory Allocation Choices," Management Science, INFORMS, vol. 61(7), pages 1531-1546, July.
    24. Gachter, Simon & Fehr, Ernst, 1999. "Collective action as a social exchange," Journal of Economic Behavior & Organization, Elsevier, vol. 39(4), pages 341-369, July.
    25. Urs Fischbacher, 2007. "z-Tree: Zurich toolbox for ready-made economic experiments," Experimental Economics, Springer;Economic Science Association, vol. 10(2), pages 171-178, June.
    26. Dirk Engelmann & Martin Strobel, 2004. "Inequality Aversion, Efficiency, and Maximin Preferences in Simple Distribution Experiments," American Economic Review, American Economic Association, vol. 94(4), pages 857-869, September.
    27. Bruno S. Frey & Iris Bohnet, 1999. "Social Distance and Other-Regarding Behavior in Dictator Games: Comment," American Economic Review, American Economic Association, vol. 89(1), pages 335-339, March.
    28. David Dranove & Daniel Kessler & Mark McClellan & Mark Satterthwaite, 2003. "Is More Information Better? The Effects of "Report Cards" on Health Care Providers," Journal of Political Economy, University of Chicago Press, vol. 111(3), pages 555-588, June.
    29. Godager, Geir & Iversen, Tor & Hennig-Schmidt, Heike, 2013. "Does performance disclosure influence physicians’ medical decisions? An experimental analysis," HERO Online Working Paper Series 2013:1, University of Oslo, Health Economics Research Programme.
    30. David Dranove & Ginger Zhe Jin, 2010. "Quality Disclosure and Certification: Theory and Practice," Journal of Economic Literature, American Economic Association, vol. 48(4), pages 935-963, December.
    31. Scott, Anthony, 2000. "Economics of general practice," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 22, pages 1175-1200, Elsevier.
    32. James Andreoni & B. Douglas Bernheim, 2009. "Social Image and the 50-50 Norm: A Theoretical and Experimental Analysis of Audience Effects," Econometrica, Econometric Society, vol. 77(5), pages 1607-1636, September.
    33. 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.
    34. Armin Falk & Andrea Ichino, 2006. "Clean Evidence on Peer Effects," Journal of Labor Economics, University of Chicago Press, vol. 24(1), pages 39-58, January.
    35. Kairies, Nadja & Krieger, Miriam, 2013. "How do Non-Monetary Performance Incentives for Physicians Affect the Quality of Medical Care? – A Laboratory Experiment," Ruhr Economic Papers 414, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    36. Marco Castillo & Gregory Leo, 2010. "Moral Hazard and Reciprocity," Southern Economic Journal, Southern Economic Association, vol. 77(2), pages 271-281, October.
    37. Rege, Mari & Telle, Kjetil, 2004. "The impact of social approval and framing on cooperation in public good situations," Journal of Public Economics, Elsevier, vol. 88(7-8), pages 1625-1644, July.
    38. repec:adr:anecst:y:2011:i:101-102:p:11 is not listed on IDEAS
    39. Adriaan Soetevent, 2005. "Anonymity in giving in a natural context-a field experiment in thirty churches," Framed Field Experiments 00198, The Field Experiments Website.
    40. Elster, Jon, 1989. "Social Norms and Economic Theory," Journal of Economic Perspectives, American Economic Association, vol. 3(4), pages 99-117, Fall.
    41. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
    42. repec:zbw:rwirep:0543 is not listed on IDEAS
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    Cited by:

    1. Wang, Jian & Iversen, Tor & Hennig-Schmidt, Heike & Godager, Geir, 2019. "Are patient-regarding preferences stable? Evidence from a laboratory experiment with physicians and medical students from different countries," HERO Online Working Paper Series 2019:1, University of Oslo, Health Economics Research Programme.
    2. Galina Besstremyannaya & Sergei Golovan, 2019. "Physician’s altruism in incentive contracts: Medicare’s quality race," CINCH Working Paper Series 1903, Universitaet Duisburg-Essen, Competent in Competition and Health.
    3. Jared Rubin & Anya Samek & Roman M. Sheremeta, 2018. "Loss aversion and the quantity–quality tradeoff," Experimental Economics, Springer;Economic Science Association, vol. 21(2), pages 292-315, June.
    4. David Bardey & Samuel Kembou Nzalé & Bruno Ventelou, 2018. "Physicians’ incentives to adopt personalized medicine: experimental evidence," Documentos CEDE 016969, Universidad de los Andes - CEDE.
    5. Brosig-Koch, Jeannette & Hennig-Schmidt, Heike & Kairies-Schwarz, Nadja & Wiesen, Daniel, 2016. "Physician performance pay: Evidence from a laboratory experiment," Ruhr Economic Papers 658, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    6. Cheo, Roland & Ge, Ge & Godager, Geir & Liu, Rugang & Wang, Qiqi & Wang, Jian, 2018. "The effect of a mystery shopper scheme on prescriptions in primary care," HERO Online Working Paper Series 2018:1, University of Oslo, Health Economics Research Programme.
    7. Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2016. "Patient Choice, Entry, and the Quality of Primary Care: Evidence from Swedish Reforms," Working Papers 2016:36, Lund University, Department of Economics, revised 27 Jun 2018.
    8. Godager, Geir & Hennig-Schmidt, Heike & Iversen, Tor, 2016. "Does performance disclosure influence physicians’ medical decisions? An experimental study," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 36-46.

    More about this item

    Keywords

    Physician payment system; laboratory experiment; incentives; transparency; fee-for-service; information and product quality;

    JEL classification:

    • C91 - Mathematical and Quantitative Methods - - Design of Experiments - - - Laboratory, Individual Behavior
    • H40 - Public Economics - - Publicly Provided Goods - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J33 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Compensation Packages; Payment Methods
    • L15 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Information and Product Quality

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