Medical ethics: enhanced or undermined by modes of payment?

详细信息    查看全文

• 作者：Peter Zweifel ; Katharina Janus
• 关键词：Medical ethics ; Physician behavior ; Mode of payment ; Fee ; for ; service ; Prospective payment ; Pay ; for ; performance ; Endogenous preferences
• 刊名：The European Journal of Health Economics
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：18
• 期：1
• 页码：119-129
• 全文大小：
• 刊物类别：Business and Economics
• 刊物主题：Public Health; Health Economics; Public Finance; Pharmacoeconomics and Health Outcomes; Economic Policy; Health Care Management;
• 出版者：Springer Berlin Heidelberg
• ISSN：1618-7601
• 卷排序：18

文摘

BackgroundIn the medical literature [1, 2, 7], the view prevails that any change away from fee-for-service (FFS) jeopardizes medical ethics, defined as motivational preference in this article. The objective of this contribution is to test this hypothesis by first developing two theoretical models of behavior, building on the pioneering works of Ellis and McGuire [4] and Pauly and Redisch [11]. Medical ethics is reflected by a parameter α, which indicates how much importance the physician attributes to patient well-being relative to his or her own income. Accordingly, a weakening of ethical orientation amounts to a fall in the value of α. While traditional economic theory takes preferences as predetermined, more recent contributions view them as endogenous (see, e.g., Frey and Oberholzer-Gee [5]).