Hospital’s activity-based financing system and manager: physician interaction

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• 作者：David Crainich (1) d.crainich@ieseg.fr
  Hervé Leleu (1) h.leleu@ieseg.fr
  Ana Mauleon (2) mauleon@fusl.ac.be
• 关键词：Hospital’s financing system – Strategic interaction – Activity ; based payment system
• 刊名：The European Journal of Health Economics
• 出版年：2011
• 出版时间：October 2011
• 年：2011
• 卷：12
• 期：5
• 页码：417-427
• 全文大小：279.9 KB
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• 作者单位：1. CNRS/LEM (UMR 8179), IéSEG School of Management, Lille, France2. FNRS and CEREC, Facultés Universitaires Saint-Louis, and CORE, UCLouvain, Brussels, Belgium
• 刊物类别：Business and Economics
• 刊物主题：Economics
  Economic Policy
  Public Health
  Public Finance and Economics
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1618-7601

文摘

This paper examines the consequences of the introduction of an activity-based reimbursement system on the behavior of physicians and hospital’s managers. We consider a private for-profit sector where both hospitals and physicians are initially paid on a fee-for-service basis. We show that the benefit of the introduction of an activity-based system depends on the type of interaction between managers and physicians (simultaneous or sequential decision-making games). It is shown that, under the activity-based system, a sequential interaction with physician leader could be beneficial for both agents in the private sector. We further model an endogenous timing game à la Hamilton and Slutsky (Games Econ Behav 2: 29–46, 1990) in which the type of interaction is determined endogenously. We show that, under the activity-based system, the sequential interaction with physician leader is the unique subgame perfect equilibrium.