HEALTH SERVICES AS CREDENCE GOODS: A FIELD EXPERIMENT

• 成果类型: Article
• 署名作者: Gottschalk, Felix; Mimra, Wanda; Waibel, Christian
• 署名单位: IESEG School of Management; Swiss Federal Institutes of Technology Domain; ETH Zurich
• 刊物名称: ECONOMIC JOURNAL
• ISSN/ISSBN: 0013-0133
• DOI: 10.1093/ej/ueaa024
• 发表日期: 2020
• 页码: 1346-1383
• 关键词: agency problems; financial incentives; insurance-coverage; antibiotic abuse; induced demand; MARKET; physicians; reputation; ECONOMICS; QUALITY

摘要

Agency problems are a defining characteristic of healthcare markets. We present the results from a field experiment in the market for dental care: a test patient who does not need treatment is sent to 180 dentists to receive treatment recommendations. In the experiment, we vary the socio-economic status of the patient and whether a second opinion signal is sent. Furthermore, measures of market, practice and dentist characteristics are collected. We observe an overtreatment recommendation rate of 28% and a striking heterogeneity in treatment recommendations. Furthermore, we find significantly fewer overtreatment recommendations for patients with higher socio-economic status compared with lower socio-economic status for standard visits, suggesting a complex role for patients' socio-economic status. Competition intensity, measured by dentist density, does not have a significant influence on overtreatment. Dentists with shorter waiting times are more likely to propose unnecessary treatment.