Overtreatment and benevolent provider moral hazard: Evidence from South African doctors
成果类型：
Article
署名作者：
Lagarde, Mylene; Blaauw, Duane
署名单位：
University of London; London School Economics & Political Science; University of Witwatersrand
刊物名称：
JOURNAL OF DEVELOPMENT ECONOMICS
ISSN/ISSBN：
0304-3878
DOI：
10.1016/j.jdeveco.2022.102917
发表日期：
2022
关键词：
摘要：
Overtreatment is widespread in health, with potentially dire consequences for patients, health systems and public health. It may be fueled by providers when they do not bear the cost of treatment (moral hazard), even they do not profit financially from it (i.e. benevolent providers). We test this hypothesis by creating an exogeneous change in the incentives faced by private doctors in South Africa. We find that provider moral hazard has no effect on overtreatment in volume but fuels overtreatment in cost. By contrast, when they bear the marginal treatment cost, doctors choose cheaper drug. While these results suggest that provider moral hazard contributes to overtreatment in primary care, we consider other plausible channels, such as responses to a perceived demand for high-quality drugs or market segmentation. We discuss the potential scope for supply-side cost-sharing incentives to reduce inefficiency in future health system reforms in South Africa.