Medical Insurance Payment Incentive and Doctors Multi-tasking Execution Deviation:A new Explanatory Framework and Policy Implications

Corresponding author: WU LIN, 104511505@qq.com

DOI: 10.12201/bmr.202112.00013

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  Abstract: In the medical insurance-hospital-doctor principal-agent structure, hospitals are not the direct executing agents, but rely on doctors to perform various tasks. Medical insurance payment methods have an important incentive effect on doctors service behavior. Based on the reality of self-interest in the supply of medical services in Chinas public hospitals, this paper first constructs an innovative framework for analyzing doctors behavior featuring a triple-mechanism. Based on this framework, it explains how doctors deviations from expected agency behaviors are generated and obtained institutional space, which actually stem from the double weakening of income incentives and cost incentives, accountability constraints under the pressure-competence imbalance, and the generation of tolerance mechanisms. Finally, it is suggested that the financial, personnel, and compensation systems should continue to be improved from the perspective of building doctors income expectations and disciplinary expectations, so as to bridge the gap between doctors behaviors and policy expectations in multi-tasking agencies.

  Key words: medical insurance payment; physician behavior; dual-agency; incentive effect

  Submit time: 28 February 2022

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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