11月2日的卫生经济学workshop将邀请哈佛大学博士生、国发院校友李明强前来讲座。
以下是讲座信息,欢迎感兴趣的同学参加。
时间:2015年11月2日(周一)12:00-14:00
地点:北京大学国家发展研究院万众楼小教室
主持人:李玲
主讲人:李明强( PhD candidate at Harvard T.H. Chan School of Public Heath in Health Economics )
题目:Can Peer Monitoring Reduce Overtreatment? Evidence from a Laboratory Experiment Simulating Medical Care
摘要:Overtreatment in a medical setting has significant consequences, from financial waste to the potential for complications from treatments that are unnecessary at best. While a number of recent studies have examined how changes in incentives can reduce overtreatment rates, relatively few studies have examined the role played by institutional settings in contributing to overtreatment, in part because of the difficulty of causal identification in observational settings. This paper presents the results of a laboratory experiment based on a game that simulates decision making in a medical treatment setting where high payments for intensive treatment create incentives for overtreatment. We test how overtreatment rates are affected by: 1) providing patients with information about hospital level outcomes; 2) providing physicians with information about peers’ treatment decisions; 3) providing information and allowing for peer-selection by physicians. Theoretical analysis predicts that peer selection can produce hospitals that sustain higher level of physician good behavior. The experimental results suggest that the peer-information intervention only reduces overtreatment by a statistically insignificant amount. By contrast, the peer selection intervention significantly reduces overtreatment. In the peer selection intervention, overtreatments at the hospitals to which most doctors apply approach zero. We also find patients are more likely to see a doctor from the hospital that maintains a low overtreatment rate. Our results suggest that institutional details can be important factors in designing health systems that minimize overtreatment and improve patients’ trust.