One size does not fit all: investigating doctors' stated preference heterogeneity for job incentives to inform policy in Thailand.
This study investigates heterogeneity in Thai doctors' job preferences at the beginning of their career, with a view to inform the design of effective policies to retain them in rural areas. A discrete choice experiment was designed and administered to 198 young doctors. We analysed the data using several specifications of a random parameter model to account for various sources of preference heterogeneity. By modelling preference heterogeneity, we showed how sensitivity to different incentives varied in different sections of the population. In particular, doctors from rural backgrounds were more sensitive than others to a 45% salary increase and having a post near their home province, but they were less sensitive to a reduction in the number of on-call nights. On the basis of the model results, the effects of two types of interventions were simulated: introducing various incentives and modifying the population structure. The results of the simulations provide multiple elements for consideration for policy-makers interested in designing effective interventions. They also underline the interest of modelling preference heterogeneity carefully.
London School of Hygiene and Tropical Medicine, Department of Global Health and Development, London, UK.
Mylene
M
Lagarde
Nonglak
N
Pagaiya
Viroj
V
Tangcharoensathian
Duane
D
Blaauw
D003625:Data Collection; D005260:Female; D006291:Health Policy; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008507:Medically Underserved Area; D017059:Models, Econometric; D015233:Models, Statistical; D010816:Physician Incentive Plans / Q000191:economics / Q000458:organization & administration; D010820:Physicians / Q000191:economics / Q000523:psychology* / Q000600:supply & distribution; D019035:Rural Health Services; D012456:Salaries and Fringe Benefits / Q000191:economics; D013785:Thailand; D019037:Urban Health Services; D000078329:Workforce
Thailand; discrete choice experiments; doctors; job preferences; preference heterogeneity; random parameter logit model