Physician Motivation and the Structure of Incentives in Prepaid Group Practice: A Theoretical and Empirical Study
| dc.contributor.author | Tinkler, Sarah Elizabeth | |
| dc.date.accessioned | 2024-12-11T18:24:16Z | |
| dc.date.available | 2024-12-11T18:24:16Z | |
| dc.date.issued | 1989-12 | |
| dc.description | 123 pages | |
| dc.description.abstract | This dissertation explores the issue of how institutional structures in the medical industry influence physician behavior. The analysis is particularly concerned with prepaid group practices, an organizational type that has tripled its enrollment since 1981. By 1988 more than thirty million Americans were enrolled in prepaid group practices . The theoretical analysis predicts that physician labor supply is sensitive to the way in which physicians are paid . Specifically, salaried physicians supply less labor than wage earning physicians because they do not receive payment based on marginal work effort . An "ethical" physician will have a greater supply of both labor and medical care than a "standard optimizing" physician, although still not necessarily the "appropriate" level. Finally, usage of nonphysician medical inputs also differs depending on the way in which the physician is paid. Under some incentive schemes the physician tends to overuse inputs other than his own time. The model predicts that only profit-sharing physicians (both "ethical" and "standard optimizing") and "standard optimizing" salaried physicians will use medical inputs efficiently . The dissertation also reports a test of one of the important theoretical results: Salaried physicians supply less labor than physicians working under incentive based reimbursement . Estimation of simultaneous labor demand and supply functions using data on American primary care physicians for the year 1984 confirms the theoretical prediction . A further result of the estimation is that salaried status does not affect the hourly wage of physicians. | |
| dc.identifier.orcid | https://orcid.org/0000-0002-3902-9199 | |
| dc.identifier.uri | https://hdl.handle.net/1794/30228 | |
| dc.language.iso | en_US | |
| dc.publisher | University of Oregon | |
| dc.rights | Creative Commons BY-NC-ND 4.0-US | |
| dc.rights | UO theses and dissertations are provided for research and educational purposes and may be under copyright by the author or the author’s heirs. Please contact us <mailto:scholars@uoregon.edu> with any questions or comments. In your email, please be sure to include the URL and title of the specific items of your inquiry. | |
| dc.subject | economics, institutional structures, physician behavior, physician labor, physician-patient relationship, labor supply, medical care | |
| dc.title | Physician Motivation and the Structure of Incentives in Prepaid Group Practice: A Theoretical and Empirical Study | |
| dc.type | Thesis / Dissertation |