Clinical response of salaried consultants to economic incentives.
Several studies have found a relation between economic incentives and physicians' clinical decisions. The bulk of these studies deals with data from private organisations providing medical care. The purpose of the present study is to explore whether a similar relationship is valid in a system where hospital care is provided by salaried physicians in the public sector. A distinction is made between medical and economic prioritysetting. If the relative fees influence the proportion of outpatient surgery or the compositions of treatments, economic prioritysetting is said to take place. Data were collected from a sample of Norwegian hospitals. The main findings of the empirical section can be summarised in two points: (i) Economic prioritysetting seems to be applied in the choice between inpatient and outpatient surgical treatment for patients with an identical diagnosis. (ii) Medical priority setting seems to be applied in the priority among patients with different diagnoses.
Iversen
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University of Oslo, Norway.
D000556:Ambulatory Surgical Procedures / Q000191:economics* / Q000706:statistics & numerical data; D003657:Decision Making; D005251:Fees, Medical / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data; D006292:Health Priorities / Q000191:economics*; D006302:Health Services Research; D017722:Hospital Charges / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000191:economics*; D006801:Humans; D008505:Medical Staff, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D017059:Models, Econometric; D009042:Motivation; D009664:Norway; D009873:Operating Rooms / Q000191:economics* / Q000706:statistics & numerical data; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000191:economics; D012456:Salaries and Fringe Benefits; D012494:Sampling Studies; D012935:Social Justice; D013514:Surgical Procedures, Operative / Q000191:economics / Q000706:statistics & numerical data*; D000078329:Workforce