提供者倾向于为患者带来更大的健康益处,这与更高的护理质量有关。

IF 1.5 4区 经济学 Q3 BUSINESS, FINANCE
Seema Kacker, Tin Aung, Dominic Montagu, David Bishai
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引用次数: 0

摘要

卫生服务提供者行为的标准理论表明,卫生服务提供者的动机是利润和病人健康利益的利他主义利益。很少有详细的经验数据来衡量利润和患者健康结果之间的相对偏好。此外,很难从经验上评估这些相对偏好如何影响护理质量。本研究使用来自缅甸农村的独特数据集来评估相对于提供者利润的治疗效果的异质性偏好,以及这些偏好对提供者诊断和治疗质量的影响。通过对187家供应商的联合调查数据,我们估计了更高的治疗效果和更高的利润的边际效用,以及这些结果之间的边际替代率。我们还使用先前验证的观察患者模拟测量了这些提供者对疟疾的诊断和治疗质量。提供者从治疗效果获得的效用与从更高利润获得的效用之间存在实质性的异质性。较高的治疗效果边际效用与提供者的治疗质量正相关,较高的利润边际效用与诊断质量负相关。我们发现,效用边际效用与利润边际效用的比值对护理质量没有一致的影响。我们的研究结果表明,提供者对利润和治疗效果的偏好各不相同,那些更重视治疗效果的提供者提供更高质量的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Providers preferences towards greater patient health benefit is associated with higher quality of care.

Standard theories of health provider behavior suggest that providers are motivated by both profit and an altruistic interest in patient health benefit. Detailed empirical data are seldom available to measure relative preferences between profit and patient health outcomes. Furthermore, it is difficult to empirically assess how these relative preferences affect quality of care. This study uses a unique dataset from rural Myanmar to assess heterogeneous preferences toward treatment efficacy relative to provider profit and the impact of these preferences on the quality of provider diagnosis and treatment. Using conjoint survey data from 187 providers, we estimated the marginal utilities of higher treatment efficacy and of higher profit, and the marginal rate of substitution between these outcomes. We also measured the quality of diagnosis and treatment for malaria among these providers using a previously validated observed patient simulation. There is substantial heterogeneity in providers' utility from treatment efficacy versus utility from higher profits. Higher marginal utility from treatment efficacy is positively associated with the quality of treatment among providers, and higher marginal utility from profit are negatively associated with quality of diagnosis. We found no consistent effect of the ratio of marginal utility of efficacy vs marginal utility of profit on quality of care. Our findings suggest that providers vary in their preferences towards profit and treatment efficacy, with those providers that place greater weight on treatment efficacy providing higher quality of care.

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来源期刊
CiteScore
3.60
自引率
0.00%
发文量
18
期刊介绍: The focus of the International Journal of Health Economics and Management is on health care systems and on the behavior of consumers, patients, and providers of such services. The links among management, public policy, payment, and performance are core topics of the relaunched journal. The demand for health care and its cost remain central concerns. Even as medical innovation allows providers to improve the lives of their patients, questions remain about how to efficiently deliver health care services, how to pay for it, and who should pay for it. These are central questions facing innovators, providers, and payers in the public and private sectors. One key to answering these questions is to understand how people choose among alternative arrangements, either in markets or through the political process. The choices made by healthcare managers concerning the organization and production of that care are also crucial. There is an important connection between the management of a health care system and its economic performance. The primary audience for this journal will be health economists and researchers in health management, along with the larger group of health services researchers. In addition, research and policy analysis reported in the journal should be of interest to health care providers, managers and policymakers, who need to know about the pressures facing insurers and governments, with consequences for regulation and mandates. The editors of the journal encourage submissions that analyze the behavior and interaction of the actors in health care, viz. consumers, providers, insurers, and governments. Preference will be given to contributions that combine theoretical with empirical work, evaluate conflicting findings, present new information, or compare experiences between countries and jurisdictions. In addition to conventional research articles, the journal will include specific subsections for shorter concise research findings and cont ributions to management and policy that provide important descriptive data or arguments about what policies follow from research findings. The composition of the editorial board is designed to cover the range of interest among economics and management researchers.Officially cited as: Int J Health Econ ManagFrom 2001 to 2014 the journal was published as International Journal of Health Care Finance and Economics. (Articles published in Vol. 1-14 officially cited as: Int J Health Care Finance Econ)
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