Incentives for Dentists in Public Service: Evidence from a Natural Experiment

• 成果类型: Article
• 署名作者: Chalkley, Martin; Tilley, Colin; Young, Linda; Bonetti, Debbie; Clarkson, Jan
• 署名单位: University of Dundee
• 刊物名称: JOURNAL OF PUBLIC ADMINISTRATION RESEARCH AND THEORY
• ISSN/ISSBN: 1053-1858
• DOI: 10.1093/jopart/muq025
• 发表日期: 2010
• 页码: I207-I223
• 关键词: dental-care; health-services; access; motivation; CHILDREN; BEHAVIOR; PRIVATE; knights; payment; english

摘要

How can independent physician contractors be motivated to contribute to public service health care? We consider evidence, derived from a natural experiment in the UK publicly funded dental care system, concerning the efficacy of using a contractual mechanism that provides explicit rewards for increased service provision against the alternative of offering an employment-like relationship. We find that dentists who were moved from quasi-employment to an activity-based incentive contract increased their activity in the publicly funded service by 26%. We also find and quantify evidence of considerable variation between suppliers, which suggests that factors such as an individual's intrinsic motivation, professional standards, and preferences are important moderators of financial incentives.