Universität zu Köln

Groß, Mona (2021). Four Contributions to Experimental Health Economics. PhD thesis, Universität zu Köln.

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Abstract

Chapter 1 “The effects of audits and fines on upcoding in neonatology”: The chapter provides causal evidence on the effect of random audits with different probabilities and financial consequences on dishonest reporting of birth weights in neonatology. The results show that audits with low detection probabilities only reduce fraudulent birth-weight reporting, when they are coupled with fines for fraudulent reporting. For audit policies with fines, increasing the probability of an audit only effectively enhances honest reporting, when switching from detectable to less gainful undetectable upcoding is not feasible. Chapter 2 “Physicians’ incentives, patients’ characteristics, and quality of care: A systematic experimental comparison of fee-for-service, capitation, and pay for performance”: This chapter presents causal evidence from a series of controlled experiments with physicians, medical students, and non-medical students about the effects of performance pay on the quantity and quality of care with heterogeneous patient types. Behavioral data show that performance pay significantly reduces non-optimal service provision under fee-for-service and capitation and enhances the quality of care. The effect sizes depend on the patients’ severity of illness. The effect of performance pay and fee-for-service on the quality of care decreases in the patients’ severity of illness, while it increases in severity for performance pay and capitation. Chapter 3 “Physician performance pay and personality traits”: The chapter explores how responses to performance incentives for physicians aimed at improving the quality of care relate to an individual’s personality traits. This analysis uses the experimental data introduced in Chapter 2. Beyond the experimental evidence that performance pay significantly improves the quality of care, I find differences in the provided quality of care for some personality traits under capitation payments but not under fee-for-service. More conscientious and more agreeable individuals respond significantly less strong to incentives under performance pay blended with capitation. Other personality traits are not significantly related to individuals’ behavior. These findings can be informative for incentivizing physicians better and sorting them into incentive schemes. Chapter 4 “Physician altruism: The role of medical education”: The chapter presents structural estimates on experimental data from a large sample of German medical students varying in their study progresses. The estimates reveal substantial heterogeneity in altruistic preferences across study cohorts. Patient-regarding altruism is highest for freshmen, declines for the students in the pre-clinical and clinical study phase, and tends to increase for practical-year students who are assisting in clinical practice. Across individuals, patient-regarding altruism is higher for females and increases in general altruism. Altruistic subjects have lower income expectations and are more likely to choose surgery and pediatrics as their preferred specialty.

Item Type:	Thesis (PhD thesis)
Creators:	Creators Email ORCID ORCID Put Code Groß, Mona UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-534012
Date:	2021
Language:	English
Faculty:	Faculty of Management, Economy and Social Sciences
Divisions:	Faculty of Management, Economics and Social Sciences > Business Administration > Health Economics > Professorship for Business Administration and Health Care Management
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Behavioral Economics UNSPECIFIED Laboratory Experiments UNSPECIFIED Artefactual Field Experiments UNSPECIFIED Financial Incentives UNSPECIFIED Health Economics UNSPECIFIED
Date of oral exam:	14 September 2021
Referee:	Name Academic Title Wiesen, Daniel Prof. Dr. Kuntz, Ludwig Prof. Dr.
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/53401