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Physician behavior under prospective payment schemes: Evidence from artefactual field and lab experiments

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  • Hafner, Lucas
  • Reif, Simon
  • Seebauer, Michael

Abstract

Recent experimental studies analyze the behavior of physicians towards patients and find that physicians care for their own profit as well as patient benefit. In this paper, we extend the experimental analysis of the physician decision problem by adding a third party representing the health insurance which finances medical service provision. Our results show that physicians take into account the payoffs of the third party, which can lead to underprovision of medical services. We conduct a laboratory experiment in neutral as well as medical framing using students and medical doctors as subjects. Subjects in the medically framed experiments behave weakly more patient orientated in contrast to neutral framing. A sample of medical doctors exhibits comparable behavior to students with medical framing.

Suggested Citation

  • Hafner, Lucas & Reif, Simon & Seebauer, Michael, 2017. "Physician behavior under prospective payment schemes: Evidence from artefactual field and lab experiments," FAU Discussion Papers in Economics 18/2017, Friedrich-Alexander University Erlangen-Nuremberg, Institute for Economics.
    • Handle: RePEc:zbw:iwqwdp:182017
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    Cited by:

    1. Jeannette Brosig‐Koch & Burkhard Hehenkamp & Johanna Kokot, 2023. "Who benefits from quality competition in health care? A theory and a laboratory experiment on the relevance of patient characteristics," Health Economics, John Wiley & Sons, Ltd., vol. 32(8), pages 1785-1817, August.
    2. Brosig-Koch, Jeannette & Hennig-Schmidt, Heike & Kairies-Schwarz, Nadja & Kokot, Johanna & Wiesen, Daniel, 2024. "A new look at physicians’ responses to financial incentives: Quality of care, practice characteristics, and motivations," Journal of Health Economics, Elsevier, vol. 94(C).
    3. Bardey, David & Kembou, Samuel & Ventelou, Bruno, 2021. "Physicians’ incentives to adopt personalised medicine: Experimental evidence," Journal of Economic Behavior & Organization, Elsevier, vol. 191(C), pages 686-713.
    4. Wang, Jian & Iversen, Tor & Hennig-Schmidt, Heike & Godager, Geir, 2020. "Are patient-regarding preferences stable? Evidence from a laboratory experiment with physicians and medical students from different countries," European Economic Review, Elsevier, vol. 125(C).
    5. Silvia Angerer & Daniela Glätzle-Rützler & Christian Waibel, 2021. "Trust in health care credence goods: Experimental evidence on framing and subject pool effects," Working Papers 2021-13, Faculty of Economics and Statistics, Universität Innsbruck.
    6. Claudia Keser & Claude Montmarquette & Martin Schmidt & Cornelius Schnitzler, 2020. "Custom-made health-care: an experimental investigation," Health Economics Review, Springer, vol. 10(1), pages 1-12, December.
    7. Massimo Finocchiaro Castro & Calogero Guccio & Domenica Romeo, 2024. "Looking inside the lab: a systematic literature review of economic experiments in health service provision," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(7), pages 1177-1204, September.
    8. Finocchiaro Castro, Massimo & Guccio, Calogero & Romeo, Domenica, 2022. "A systematic literature review of 10 years of behavioral research on health services," EconStor Preprints 266248, ZBW - Leibniz Information Centre for Economics.
    9. Johann Han & Nadja Kairies-Schwarz & Markus Vomhof, 2024. "Strategic behaviour and decision making in competitive hospital markets: an experimental investigation," International Journal of Health Economics and Management, Springer, vol. 24(3), pages 333-355, September.
    10. Nadja Kairies-Schwarz & Claudia Souček, 2020. "Performance Pay in Hospitals: An Experiment on Bonus–Malus Incentives," IJERPH, MDPI, vol. 17(22), pages 1-29, November.
    11. Atehortua, S & Rodríguez-Valencia, A, 2021. "Physician s Allocation Preferences under Scarcity and Uncertainty," Documentos de Trabajo 19665, Universidad del Rosario.
    12. Brosig-Koch, Jeannette & Groß, Mona & Hennig-Schmidt, Heike & Kairies-Schwarz, Nadja & Wiesen, Daniel, 2021. "Physicians' incentives, patients' characteristics, and quality of care: A systematic experimental comparison of fee-for-service, capitation, and pay for performance," Ruhr Economic Papers 923, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    13. Attema, Arthur E. & Galizzi, Matteo M. & Groß, Mona & Hennig-Schmidt, Heike & Karay, Yassin & L’Haridon, Olivier & Wiesen, Daniel, 2023. "The formation of physician altruism," Journal of Health Economics, Elsevier, vol. 87(C).
    14. Waibel, Christian & Wiesen, Daniel, 2021. "An experiment on referrals in health care," European Economic Review, Elsevier, vol. 131(C).
    15. Byambadalai, Undral & Ma, Ching-to Albert & Wiesen, Daniel, 2023. "Changing preferences: An experiment and estimation of market-incentive effects on altruism," Journal of Health Economics, Elsevier, vol. 92(C).
    16. Franziska Brendel & Lisa Einhaus & Franziska Then, 2021. "Resource scarcity and prioritization decisions in medical care: A lab experiment with heterogeneous patient types," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 470-477, February.
    17. Angerer, Silvia & Glätzle-Rützler, Daniela & Waibel, Christian, 2023. "Framing and subject pool effects in healthcare credence goods," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 103(C).

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    More about this item

    Keywords

    health economic experiment; framing; physician behavior; prospective payment schemes;
    All these keywords.

    JEL classification:

    • C91 - Mathematical and Quantitative Methods - - Design of Experiments - - - Laboratory, Individual Behavior
    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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