scholarly journals Stimulants économiques et utilisation des services médicaux

2009 ◽  
Vol 56 (2) ◽  
pp. 264-296 ◽  
Author(s):  
André-Pierre Contandriopoulos
Keyword(s):  
Economic Model ◽  
Financial Incentives ◽  
Physician Behavior ◽  
Economic Incentives ◽  
Present Form ◽  
Medical Services ◽  
Factors Affecting ◽  
Utilisation Des Services ◽  
Fee Schedule

Abstract Having demonstrated that the traditional economic model of the market cannot be used in its present form to understand what is happening in the field of medical services, a presentation will be made of the factors affecting the behavior of physicians as purveyors of services, thus showing the importance of analyzing the influence of economic incentives on physician behavior. The analysis consists of measuring the change in the practice profiles of physicians from 1971 to 1973, and evaluating the influence of the fee schedule on this change. This research allows us to show that the personal characterictics of physicians, the characteristics associated with the organization of their practice and the area in which they practise are only very slightly related to the changes in the mix of the medical services produced by physicians; that the change in the profile of practice cannot be associated with changes in the populations' needs, and that the financial incentives incorporated in the fee schedule have been found to be mainly responsible for the shifts observed in the profiles of practice. We conclude by showing how these results are compatible with the hypothesis that physicians can influence demand for medical services.

Criteria and barriers for the application of green building features in Hong Kong

2018 ◽  
Vol 7 (3/4) ◽  
pp. 251-276 ◽  
Author(s):  
Jayantha Wadu Mesthrige ◽  
Ho Yuk Kwong
Keyword(s):  
Hong Kong ◽  
Financial Incentives ◽  
Group Discussion ◽  
Green Building ◽  
Building Sector ◽  
Content Type ◽  
Factors Affecting ◽  
Barriers To Implementation ◽  
Multi Method Approach ◽  
Method Approach

Purpose An understanding about the criteria determining the successful application of green features, and the barriers to implementation is essential in order to promote and enhance green building development. The purpose of this paper is twofold: first, the criteria determining the success of GBFs; and second, the barriers to implementing GBFs in Hong Kong. Design/methodology/approach A multi-method approach comprising a comprehensive questionnaire survey and a semi-structured group discussion with construction professionals, along with three case studies was adopted to address these two issues. Findings Findings suggest that although environmental performance is the most significant criterion, the living quality of occupants and the costs of green features play a crucial role in determining the success of their application. However, the environmental aspects of buildings are not sufficient for rating or determining the greenness level of a building. As for barriers, the green cost implications; the structural unsuitability of the current stock of old buildings; and the lack of financial incentives were found to be crucial barriers preventing the application of green features in the Hong Kong building sector. Originality/value GBFs have received extensive attentions by the academia and industry. This paper used a mix method approach by exploring success criteria and barriers to implementing green features in the building sector in Hong Kong. As green building development is still a contemporary subject of discussion, this study would be beneficial to decision makers as it identifies the criteria determining the success of green building adoption and barriers to implementation of such features. Hence, relevant stakeholders will have better understanding of the factors affecting the adoption of GBFs.

scholarly journals Swedish House Owners’ Intentions Towards Renovations: Is there a Market for One-Stop-Shop?

Buildings ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. 164 ◽  
Author(s):  
Georgios Pardalis ◽  
Krushna Mahapatra ◽  
Giangiacomo Bravo ◽  
Brijesh Mainali
Keyword(s):  
Financial Incentives ◽  
Energy Savings ◽  
Online Questionnaire ◽  
Level Of Involvement ◽  
Factors Affecting ◽  
Younger Age ◽  
One Stop ◽  
Near Future ◽  
Selection Of

In this paper, we examine factors affecting owners’ intention for renovation of their detached houses. Furthermore, we analyze their interest in choosing a one-stop-shop (OSS) service for the renovation, even though such a concept is not yet established in Sweden, but emerging in other parts of Europe. Our study is based on responses to an online questionnaire survey of 971 house owners residing in Kronoberg Region in Sweden. About 76% of the respondents intend to renovate in the near future, with approximately 71% of them preferring to renovate individual components of their dwelling and 5% to renovate their whole house in steps. House owners of younger age, higher income, higher education, and those with an interest for environmental issues, were the ones most interested in physical renovations, which improves energy efficiency of the building. For those house owners, one-stop-shop can facilitate the decision-making process, and help them to choose those measures that will improve their quality of life. Approximately 20% of the respondents had a positive view towards an one-stop-shop, which is an indicator that market for such a service exists. Parameters such as quality of work, cost and energy savings and specification of measures to be adopted are the key for the promotion of one-stop-shop. Additionally, house owners want to have a certain level of involvement in the selection of actors performing the renovation. Moreover, financial incentives, e.g., loans, do not play a significant role for the selection of one-stop-shop, but act as complementary motive for house owners.

The effectiveness of incentives to postpone retirement: evidence from Italy

2017 ◽  
Vol 18 (2) ◽  
pp. 220-246
Author(s):  
IRENE FERRARI
Keyword(s):  
Low Income ◽  
Household Income ◽  
Financial Incentives ◽  
Economic Incentives ◽  
Before And After ◽  
Private And Public ◽  
Social Security Wealth ◽  
Using Data ◽  
Public Workers ◽  
Limited Period

AbstractThis paper investigates whether financial incentives may be used as an effective device to induce workers to postpone retirement by evaluating the Italian so-called ‘super-bonus’ reform. The bonus consisted of economic incentives given for a limited period to private sector workers who had reached the requirements for seniority pension but who chose to postpone retirement. Using data from the Bank of Italy Survey on Household Income and Wealth, this paper assesses the effect of the bonus on the decision to postpone retirement, by comparing private and public workers before and after the reform. Results suggest a 30% reduction in seniority retirement probability, despite the fact that, when changes in social security wealth are taken into account, the bonus actually provided a negative incentive for most workers. Results also suggest that the effect of the reform was driven by low-income workers. Some evidence is presented showing that liquidity constraints and financial (il)literacy may help to interpret these results.

scholarly journals Ex-Ante Study of Biofuel Policies–Analyzing Policy-Induced Flexibility

2021 ◽  
Vol 14 (1) ◽  
pp. 147
Author(s):  
Inka Ruponen ◽  
Mariia Kozlova ◽  
Mikael Collan
Keyword(s):  
Financial Incentives ◽  
Low Carbon ◽  
Fuel Production ◽  
Factors Affecting ◽  
Low Carbon Economy ◽  
Profitability Analysis ◽  
Analysis Methods ◽  
Tax Relief ◽  
Biofuel Policies ◽  
Policy Types

A variety of policy types are available to foster the transition to a low-carbon economy. In every sector, including transportation, heat and power production, policymakers face the choice of what type of policy to adopt. For this choice, it is crucial to understand how different mechanisms incentivize investments in terms of improving their profitability, shaping the flexibility available for investors, and how they are affected by the surrounding uncertainty. This paper focuses on transportation-biofuel policies, particularly on the financial incentives put on the bio-component of fuel and the combination of using penalties and tax-relief. Delivery of vital policymaking insights by using two modern simple-to-use profitability analysis methods, the pay-off method and the simulation decomposition method, is illustrated. Both methods enable the incorporation of uncertainty into the profitability analyses, and thus generate insight about the flexibilities involved, and the factors affecting the results. The results show that the combination of penalties and tax-relief is a way to steer fuel-production towards sustainability. The two methods used for analysis complement each other and provide important insights for analysis and decision-making beyond what the commonly used profitability analysis methods typically provide.

scholarly journals Całkowicie prywatna opieka medyczna — próba zarysu

Ekonomia ◽  
2020 ◽  
Vol 26 (1) ◽  
pp. 155-195
Author(s):  
Stanisław Wójtowicz ◽  
Kamil Rozynek
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Service Providers ◽  
Free Market ◽  
Medical Insurance ◽  
Economic Incentives ◽  
The State ◽  
Medical Services ◽  
Market Mechanisms ◽  
Quality Of Medical Care

In this paper, we explore what the market for medical services and products could look like if the state completely withdrew from the area of medical care. In section 1, we demonstrate that medical services would be purchased mainly through direct payments and medical insurance. We analyse two models of medical insurance: guaranteed renewable insurance and health-status insurance. Other types of insurance that may emerge on the market are also discussed. In section 2, we exam-ine how the privatisation of the health-care system would affect the prices of medical services. We analyse fundamental problems of the state-run health care and discuss how they contribute to small-er supply and higher prices of medical services. We then describe how the introduction of market mechanisms would allow to solve many of these problems. We argue that internalisation of the costs of medical care in a free market order would create strong economic incentives for individuals to take better care of their health, and we contrast this with the state-run health care in which these costs are externalised. In section 3, we explore how medical services could be obtained by individuals without sufficient funds. In section 4, we discuss how the quality of medical care could be ensured without the help of the state. We argue that competition between service providers would be the main guarantor of quality. We also identify mechanisms that would lead to spontaneous emergence of a system of private medical licencing.

scholarly journals Why clinicians overtest: development of a thematic framework

2020 ◽  
Author(s):  
Justin H Lam ◽  
Kristen Pickles ◽  
Fiona Stanaway ◽  
Katy JL Bell
Keyword(s):  
Financial Incentives ◽  
Cognitive Biases ◽  
New Technology ◽  
Group Discussion ◽  
Unintended Consequences ◽  
Factors Affecting ◽  
Medline Search ◽  
Targeted Interventions ◽  
Attitudes And Practices ◽  
Thematic Framework

Abstract Background: Medical tests provide important information to guide clinical management. Overtesting, however, may cause harm to patients and the healthcare system, including through misdiagnosis, false positives, false negatives and overdiagnosis. Clinicians are ultimately responsible for test requests, and are therefore ideally positioned to prevent overtesting and its unintended consequences. Through this narrative literature review and workshop discussion with experts at the Preventing Overdiagnosis Conference (Sydney, 2019), we aimed to identify and establish a thematic framework of factors that influence clinicians to request non-recommended and unnecessary tests. Methods: Articles exploring factors affecting clinician test ordering behaviour were identified through a systematic search of MedLine in April 2019, forward and backward citation searches and content experts. Two authors screened abstract titles and abstracts, and two authors screened full text for inclusion. Identified factors were categorised into a preliminary framework which was subsequently presented at the PODC for iterative development.Results: The MedLine search yielded 542 articles; 55 were included. Another 10 articles identified by forward-backward citation and content experts were included, resulting in 65 articles in total. Following small group discussion with workshop participants, a revised thematic framework of factors was developed: · “Intrapersonal” – fear of malpractice and litigation; clinician knowledge and understanding; intolerance of uncertainty and risk aversion; cognitive biases and experiences; sense of medical obligation· “Interpersonal” – pressure from patients and doctor-patient relationship; pressure from colleagues and medical culture; · “Environment/context” – guidelines, protocols and policies; financial incentives and ownership of tests; time constraints, physical vulnerabilities and language barriers; availability and ease of access to tests; pre-emptive testing to facilitate subsequent care; contemporary medical practice and new technology Conclusion: This thematic framework may raise awareness of overtesting and prompt clinicians to change their test request behaviour. The development of a scale to assess clinician knowledge, attitudes and practices is planned to allow evaluation of clinician-targeted interventions to reduce overtesting.

scholarly journals Why clinicians overtest: development of a thematic framework

2020 ◽  
Author(s):  
Justin H Lam ◽  
Kristen Pickles ◽  
Fiona Stanaway ◽  
Katy JL Bell
Keyword(s):  
Financial Incentives ◽  
Cognitive Biases ◽  
New Technology ◽  
Group Discussion ◽  
Unintended Consequences ◽  
Factors Affecting ◽  
Medline Search ◽  
Targeted Interventions ◽  
Attitudes And Practices ◽  
Thematic Framework

Abstract Background: Medical tests provide important information to guide clinical management. Overtesting, however, may cause harm to patients and the healthcare system, including through misdiagnosis, false positives, false negatives and overdiagnosis. Clinicians are ultimately responsible for test requests, and are therefore ideally positioned to prevent overtesting and its unintended consequences. Through this narrative literature review and workshop discussion with experts at the Preventing Overdiagnosis Conference (Sydney, 2019), we aimed to identify and establish a thematic framework of factors that influence clinicians to request non-recommended and unnecessary tests. Methods: Articles exploring factors affecting clinician test ordering behaviour were identified through a systematic search of MedLine in April 2019, forward and backward citation searches and content experts. Two authors screened abstract titles and abstracts, and two authors screened full text for inclusion. Identified factors were categorised into a preliminary framework which was subsequently presented at the PODC for iterative development.Results: The MedLine search yielded 542 articles; 55 were included. Another 10 articles identified by forward-backward citation and content experts were included, resulting in 65 articles in total. Following small group discussion with workshop participants, a revised thematic framework of factors was developed: · “Intrapersonal” – fear of malpractice and litigation; clinician knowledge and understanding; intolerance of uncertainty and risk aversion; cognitive biases and experiences; sense of medical obligation· “Interpersonal” – pressure from patients and doctor-patient relationship; pressure from colleagues and medical culture; · “Environment/context” – guidelines, protocols and policies; financial incentives and ownership of tests; time constraints, physical vulnerabilities and language barriers; availability and ease of access to tests; pre-emptive testing to facilitate subsequent care; contemporary medical practice and new technology Conclusion: This thematic framework may raise awareness of overtesting and prompt clinicians to change their test request behaviour. The development of a scale to assess clinician knowledge, attitudes and practices is planned to allow evaluation of clinician-targeted interventions to reduce overtesting.

scholarly journals Willingness to adopt wearable devices with behavioral and economic incentives by health insurance wellness programs: results of a US cross-sectional survey with multiple consumer health vignettes

2019 ◽  
Author(s):  
Diego Soliño-Fermández ◽  
Alexander Ding ◽  
Eric L. Ding ◽  
Esteban Bayro-Kaiser
Keyword(s):  
Health Promotion ◽  
Health Insurance ◽  
Financial Incentives ◽  
Data Privacy ◽  
Financial Incentive ◽  
Wellness Programs ◽  
Wearable Devices ◽  
Economic Incentives ◽  
Use Cases ◽  
Cross Sectional

Abstract Background: The number of health-related wearable devices is growing but it is not clear if Americans are willing to adopt health insurance wellness programs based on wearables and the incentives with which they would be more willing to adopt. Methods: In this cross-sectional study we used a survey methodology, usage vignettes and a dichotomous scale to examine U.S. residents’ willingness to adopt wearables (WTAW) in six use-cases where it was mandatory to use a wearable device and share the resulting data with a health insurance company. Each use-case was tested also for the influence of additional economic incentives on WTAW. Results: A total of 997 Americans across 46 states participated in the study. Most of them were 25 to 34 years old (40.22%), 57.27% were female, and 74.52% were white. On average, 69.5% of the respondents were willing to adopt health-insurance use-cases based on wearable devices, though 77.8% of them were concerned about issues related to economic benefits, data privacy and to a lesser extent, technological accuracy. WTAW was 11-18% higher among consumers in use-cases involving health promotion and disease prevention. Furthermore, additional economic incentives combined with wearables increased WTAW overall. Notably, financial incentives involving providing healthcare credits, insurance premium discount, and/or wellness product discounts had particularly greater effectiveness for increasing WTAW in the consumer use-cases involving participation: for health promotion (RR=1.06 for financial incentive, 95% CI: 1.01-1.11; P=0.018); for personalized products and services (RR=1.11 for financial incentive, 95% CI: 1.01-1.21; P=0.018); and for automated underwriting discount at annual renewal (RR=1.28 for financial incentive, 95% CI: 1.20-1.37; P<0.001). Conclusions: Under the adequate economic, data privacy and technical conditions, 2 out of 3 Americans would be willing to adopt health insurance wellness programs based on wearable devices, particularly if they have benefits related to health promotion and disease prevention, and particularly with financial incentives.

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