Overview
This research investigates the impact of different provider payment mechanisms on individual decision making. Economic behaviour suggests that the way healthcare providers are paid (e.g. monthly salary, fee-for-service, capitation), can influence their behaviour which in turn can affect both the quality and efficiency of care. However, evidence on these effects is mixed and limited by a number of methodological challenges.
The initial phase of research was conducted under laboratory conditions, using hypothetical clinical scenarios. In subsequent phases of research, a more realistic evaluation of changes introduced under the National Health Insurance Scheme in South Africa will be undertaken.
Progress
-
For the first phase, researchers have used experimental methods (DCE + experimental games) to isolate the effects of different payment mechanisms.
-
The second phase of the research began in 2016, and will study the effects of a private GP contracting policy in South Africa.
Publications
RESYST Working Paper 5 (2014) Testing the effects of doctors' remuneration schemes and altruism in a multi-tasking environment- Presentation: The medical game: social preferences and financial incentives in a multi-tasking environment
- Presentation: Carrot, stick or competition? The relative effect of P4P schemes in health care
- Presentation: Investigating provider payment mechanisms in the lab
