Incentivizing Physicians' Diagnostic Effort and Test with Moral Hazard and Adverse Selection
Códigos JEL.: D82, D86, I18
- Autores:
-
Bardey, David
Donder, Philippe de
Leroux, Marie-Louise
- Tipo de recurso:
- Work document
- Fecha de publicación:
- 2024
- Institución:
- Universidad de los Andes
- Repositorio:
- Séneca: repositorio Uniandes
- Idioma:
- eng
- OAI Identifier:
- oai:repositorio.uniandes.edu.co:1992/75218
- Acceso en línea:
- https://hdl.handle.net/1992/75218
- Palabra clave:
- Diagnostic risk
Personalized medicine
Non-responsiveness
Capitation payment
Pay-for-performance
Hidden action and hidden information
Economía
- Rights
- openAccess
- License
- https://repositorio.uniandes.edu.co/static/pdf/aceptacion_uso_es.pdf
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Incentivizing Physicians' Diagnostic Effort and Test with Moral Hazard and Adverse Selection |
| title |
Incentivizing Physicians' Diagnostic Effort and Test with Moral Hazard and Adverse Selection |
| spellingShingle |
Incentivizing Physicians' Diagnostic Effort and Test with Moral Hazard and Adverse Selection Diagnostic risk Personalized medicine Non-responsiveness Capitation payment Pay-for-performance Hidden action and hidden information Economía |
| title_short |
Incentivizing Physicians' Diagnostic Effort and Test with Moral Hazard and Adverse Selection |
| title_full |
Incentivizing Physicians' Diagnostic Effort and Test with Moral Hazard and Adverse Selection |
| title_fullStr |
Incentivizing Physicians' Diagnostic Effort and Test with Moral Hazard and Adverse Selection |
| title_full_unstemmed |
Incentivizing Physicians' Diagnostic Effort and Test with Moral Hazard and Adverse Selection |
| title_sort |
Incentivizing Physicians' Diagnostic Effort and Test with Moral Hazard and Adverse Selection |
| dc.creator.fl_str_mv |
Bardey, David Donder, Philippe de Leroux, Marie-Louise |
| dc.contributor.author.none.fl_str_mv |
Bardey, David Donder, Philippe de Leroux, Marie-Louise |
| dc.subject.keyword.none.fl_str_mv |
Diagnostic risk Personalized medicine Non-responsiveness Capitation payment Pay-for-performance Hidden action and hidden information |
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Diagnostic risk Personalized medicine Non-responsiveness Capitation payment Pay-for-performance Hidden action and hidden information Economía |
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Economía |
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Códigos JEL.: D82, D86, I18 |
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2024 |
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2024-12-02T21:44:48Z |
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2024-11 |
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eng |
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eng |
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Documentos CEDE; 2024-46 |
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https://ideas.repec.org/p/col/000089/021269.html |
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67 páginas |
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Universidad de los Andes |
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Facultad de Economía |
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Universidad de los Andes |
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Bardey, DavidDonder, Philippe deLeroux, Marie-Louise2024-12-02T21:44:48Z2024-12-02T21:44:48Z2024-111657-7191https://hdl.handle.net/1992/75218Códigos JEL.: D82, D86, I18We study a situation where physicians differing in their degree of altruism exert a diagnostic effort before deciding whether to test patients to determine the most appropriate treatment. The diagnostic effort generates an imperfect private signal of the patient’s type, while the test is perfect. At the laissez-faire, physicians exert insufficient diagnostic effort and rely excessively on testing. We show that the first-best allocation (where the degree of altruism is observable) can be decentralized by a payment scheme composed of i) a payfor- performance (P4P) part based on the number of correctly treated patients to ensure the provision of the optimal diagnostic effort, and of ii) a capitation part to ensure both the optimal testing decision and the participation of physicians. When physicians differ in their (non-observable) degree of altruism, the optimal contract is pooling rather than separating, an instance of non-responsiveness. Its uniform P4P component induces more altruistic physicians to exert a larger diagnostic effort while, to incentivize the second-best optimal testing decision, its capitation component must be contingent on the test cost.Estudiamos una situación en la que médicos que difieren en su grado de altruismo realizan un esfuerzo de diagnóstico antes de decidir si deben realizar pruebas a los pacientes para determinar el tratamiento más adecuado. El esfuerzo de diagnóstico genera una señal privada imperfecta del tipo de paciente, mientras que la prueba es perfecta. En el laissez-faire, los médicos realizan un esfuerzo de diagnóstico insuficiente y dependen excesivamente de las pruebas. Demostramos que la asignación óptima (donde el grado de altruismo es observable) puede descentralizarse mediante un esquema de pago compuesto por i) una parte de pago por desempeño (P4P) basada en el número de pacientes tratados correctamente para garantizar la provisión del esfuerzo de diagnóstico óptimo, y ii) una parte de capitación para garantizar tanto la decisión óptima de realizar pruebas como la participación de los médicos. Cuando los médicos difieren en su grado (no observable) de altruismo, el contrato óptimo es el de agrupación en lugar de separación, un ejemplo de "non-responsiveness". Su componente P4P uniforme induce a los médicos más altruistas a realizar un mayor esfuerzo diagnóstico mientras que, para incentivar la segunda mejor decisión de prueba óptima, su componente de capitación debe depender del costo de la prueba.67 páginasapplication/pdfengUniversidad de los AndesFacultad de EconomíaDocumentos CEDE; 2024-46https://ideas.repec.org/p/col/000089/021269.htmlhttps://repositorio.uniandes.edu.co/static/pdf/aceptacion_uso_es.pdfinfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Incentivizing Physicians' Diagnostic Effort and Test with Moral Hazard and Adverse SelectionDocumento de trabajoinfo:eu-repo/semantics/workingPaperinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_8042http://purl.org/coar/version/c_970fb48d4fbd8a85Texthttp://purl.org/redcol/resource_type/WPDiagnostic riskPersonalized medicineNon-responsivenessCapitation paymentPay-for-performanceHidden action and hidden informationEconomíaPublicationORIGINALdcede2024-46.pdfdcede2024-46.pdfapplication/pdf9334121https://repositorio.uniandes.edu.co/bitstreams/8a706fd5-5e60-45f2-a3e8-b330540e6e3e/download6259fd4899ae0c247974f754d344f2c4MD51LICENSElicense.txtlicense.txttext/plain; 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