Special Issue "Incentive and Market Perspectives in Health Care"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (15 December 2020).

Special Issue Editors

Prof. Dr. Randall P. Ellis
Website
Guest Editor
Ph.D., Department of Economics, Boston University, 270 Bay State Road, Boston, Massachusetts 02215, USA
Interests: risk adjustment; reimbursement systems; optimal insurance; health plan competition; the economics of mental health; health demand modeling in developing countries; and the cost-effectiveness of cancer screening
Prof. Dr. Ching-To Albert Ma
Website
Guest Editor
Ph.D., Department of Economics, Boston University, 270 Bay State Road, Boston, Massachusetts 02215, USA
Interests: incentives and payment design in the health market; competition in the health market; interaction between public and private health sectors
Special Issues and Collections in MDPI journals
Prof. Dr. Daniel Wiesen
Website
Guest Editor
Department of Business Administration and Healthcare Management, University of Cologne, Albertus-Magnus-Platz, 50923 Cologne, Germany
Interests: health economics; behavioral and experimental economics; incentives; physician behavior

Special Issue Information

Dear Colleagues,

The Special Issue entitled “Incentive and Market Perspectives in Health Care” in the International Journal of Environmental Research and Public Health, Section Health Economics aims to publish high-quality research articles contributing to a better understanding of health care markets. Its scope includes, but is not limited to, topics on consumer and provider interactions, health insurance, government policy and regulation, and health care market design. We welcome original scientific contributions employing rigorous theoretical modelling, state-of-the art empirical methods, or behavioral experiments.

Prof. Ching-To Albert Ma, Ph.D.
Prof. Randall P. Ellis, Ph.D.
Prof. Dr. Daniel Wiesen
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health care markets
  • incentives
  • provider payments
  • health insurance
  • hidden information and hidden action problems
  • public policies and regulations
  • market designs and experiments

Published Papers (4 papers)

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Research

Open AccessArticle
Performance Pay in Hospitals: An Experiment on Bonus–Malus Incentives
Int. J. Environ. Res. Public Health 2020, 17(22), 8320; https://doi.org/10.3390/ijerph17228320 - 10 Nov 2020
Abstract
Recent policy reforms in Germany require the introduction of a performance pay component with bonus–malus incentives in the inpatient care sector. We conduct a controlled online experiment with real hospital physicians from public hospitals and medical students in Germany, in which we investigate [...] Read more.
Recent policy reforms in Germany require the introduction of a performance pay component with bonus–malus incentives in the inpatient care sector. We conduct a controlled online experiment with real hospital physicians from public hospitals and medical students in Germany, in which we investigate the effects of introducing a performance pay component with bonus–malus incentives to a simplified version of the German Diagnosis Related Groups (DRG) system using a sequential design with stylized routine cases. In both parts, participants choose between the patient optimal and profit maximizing treatment option for the same eight stylized routine cases. We find that the introduction of bonus–malus incentives only statistically significantly increases hospital physicians’ proportion of patient optimal choices for cases with high monetary baseline DRG incentives to choose the profit maximizing option. Medical students behave qualitatively similar. However, they are statistically significantly less patient oriented than real hospital physicians, and statistically significantly increase their patient optimal decisions with the introduction of bonus–malus incentives in all stylized routine cases. Overall, our results indicate that whether the introduction of a performance pay component with bonus–malus incentives to the (German) DRG system has a positive effect on the quality of care or not particularly depends on the monetary incentives implemented in the DRG system as well as the type of participants and their initial level of patient orientation. Full article
(This article belongs to the Special Issue Incentive and Market Perspectives in Health Care)
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Open AccessArticle
Competition between Public and Private Maternity Care Providers in France: Evidence on Market Segmentation
Int. J. Environ. Res. Public Health 2020, 17(21), 7846; https://doi.org/10.3390/ijerph17217846 - 26 Oct 2020
Abstract
The purpose of this paper is to investigate the potential for segmentation in hospital markets, using the French case where private for-profit providers play an important role having nearly 25% of market shares, and where prices are regulated, leading to quality competition. Using [...] Read more.
The purpose of this paper is to investigate the potential for segmentation in hospital markets, using the French case where private for-profit providers play an important role having nearly 25% of market shares, and where prices are regulated, leading to quality competition. Using a stylized economic model of hospital competition, we investigate the potential for displacement between vertically differentiated public and private providers, focusing on maternity units where user choice is central. Building over the model, we test the following three hypotheses. First, the number of public maternity units is likely to be much larger in less populated departments than in more populated ones. Second, as the number of public maternity units decreases, the profitability constraint should allow more private players into the market. Third, private units are closer substitutes to other private units than to public units. Building an exhaustive and nationwide data set on the activity of maternity services linked to detailed data at a hospital level, we use an event study framework, which exploits two sources of variation: (1) The variation over time in the number of maternity units and (2) the variation in users’ choices. We find support for our hypotheses, indicating that segmentation is at work in these markets with asymmetrical effects between public and private sectors that need to be accounted for when deciding on public market entry or exit. Full article
(This article belongs to the Special Issue Incentive and Market Perspectives in Health Care)
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Open AccessArticle
Health Systems, Aging, and Inequity: An Example from Chile
Int. J. Environ. Res. Public Health 2020, 17(18), 6546; https://doi.org/10.3390/ijerph17186546 - 09 Sep 2020
Abstract
Background: Just like many other countries around the world, Chile is facing the challenges of demographic transition and population aging. Considering this context, the question of how prepared the health system is to deal with these challenges arises; Methods: A framework to assess [...] Read more.
Background: Just like many other countries around the world, Chile is facing the challenges of demographic transition and population aging. Considering this context, the question of how prepared the health system is to deal with these challenges arises; Methods: A framework to assess the health system’s preparedness for aging was proposed, considering the health system’s goals and features and using an equity approach. Indicators related to the health system’s goals were calculated for the year 2015 using three nationally-representative sources: health status (suicide rate), financial protection (out-of-pocket and catastrophic expenditures), and responsiveness (satisfaction). Age ratios were used to compare the system’s response to different age groups; Results: Results for Chile revealed the existence of inequities, particularly when assessing the system in terms of its ability to improve health status and financial protection. These gaps increase with age, suggesting that the Chilean health system is not prepared to meet older people’s needs; and Conclusions: These results call for a reform in the health system, as well as the need for implementing a long-term care system in the country. Full article
(This article belongs to the Special Issue Incentive and Market Perspectives in Health Care)
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Open AccessArticle
Physician Behavior under Prospective Payment Schemes—Evidence from Artefactual Field and Lab Experiments
Int. J. Environ. Res. Public Health 2020, 17(15), 5540; https://doi.org/10.3390/ijerph17155540 - 31 Jul 2020
Cited by 3
Abstract
Recent experimental studies analyze the behavior of physicians towards patients and find that physicians care for their own profit as well as patient benefit. In this paper, we extend the experimental analysis of the physician decision problem by adding a third party which [...] Read more.
Recent experimental studies analyze the behavior of physicians towards patients and find that physicians care for their own profit as well as patient benefit. In this paper, we extend the experimental analysis of the physician decision problem by adding a third party which represents the health insurance that finances medical service provision under a prospective payment scheme. Our results show that physicians take into account the payoffs of the third party, which can lead to underprovision of medical care. We conduct a laboratory experiment in neutral as well as in medical framing using students and medical doctors as subjects. Subjects in the medically framed experiments behave weakly and are more patient orientated in contrast to neutral framing. A sample of medical doctors exhibits comparable behavior to students with medical framing. Full article
(This article belongs to the Special Issue Incentive and Market Perspectives in Health Care)
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