Doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities

This paper uses a two-sided market model of hospital competition to study the implications of di§erent remunerations schemes on the physiciansí side. The two-sided market approach is characterized by the concept of common network externality (CNE) introduced by Bardey et al. (2010). This type of ext...

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Autores Principales: Bardey, David, Cremer, Helmuth, Lozachmeur, Jean-Marie
Formato: Documento de trabajo (Working Paper)
Lenguaje:Español (Spanish)
Publicado: Universidad del Rosario 2011
Materias:
Acceso en línea:http://repository.urosario.edu.co/handle/10336/10952
id ir-10336-10952
recordtype dspace
spelling ir-10336-109522019-09-19T12:37:01Z Doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities Bardey, David Cremer, Helmuth Lozachmeur, Jean-Marie Administración general Economía del trabajo Médicos::Aspectos Económicos Salarios Administración hospitalaria Two-Sided markets Common Network Externality Providersí remuneration schemes This paper uses a two-sided market model of hospital competition to study the implications of di§erent remunerations schemes on the physiciansí side. The two-sided market approach is characterized by the concept of common network externality (CNE) introduced by Bardey et al. (2010). This type of externality occurs when occurs when both sides value, possibly with di§erent intensities, the same network externality. We explicitly introduce e§ort exerted by doctors. By increasing the number of medical acts (which involves a costly e§ort) the doctor can increase the quality of service o§ered to patients (over and above the level implied by the CNE). We Örst consider pure salary, capitation or fee-for-service schemes. Then, we study schemes that mix fee-for-service with either salary or capitation payments. We show that salary schemes (either pure or in combination with fee-for-service) are more patient friendly than (pure or mixed) capitations schemes. This comparison is exactly reversed on the providersíside. Quite surprisingly, patients always loose when a fee-for-service scheme is introduced (pure of mixed). This is true even though the fee-for-service is the only way to induce the providers to exert e§ort and it holds whatever the patientsívaluation of this e§ort. In other words, the increase in quality brought about by the fee-for-service is more than compensated by the increase in fees faced by patients. 2011 2015-10-02T17:12:54Z info:eu-repo/semantics/workingPaper info:eu-repo/semantics/acceptedVersion http://repository.urosario.edu.co/handle/10336/10952 Universidad del Rosario spa info:eu-repo/semantics/openAccess application/pdf Universidad del Rosario Facultad de Economía instname:Universidad del Rosario reponame:Repositorio Institucional EdocUR instname:Universidad del Rosario
institution EdocUR - Universidad del Rosario
collection DSpace
language Español (Spanish)
topic Administración general
Economía del trabajo
Médicos::Aspectos Económicos
Salarios
Administración hospitalaria
Two-Sided markets
Common Network Externality
Providersí remuneration schemes
spellingShingle Administración general
Economía del trabajo
Médicos::Aspectos Económicos
Salarios
Administración hospitalaria
Two-Sided markets
Common Network Externality
Providersí remuneration schemes
Bardey, David
Cremer, Helmuth
Lozachmeur, Jean-Marie
Doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities
description This paper uses a two-sided market model of hospital competition to study the implications of di§erent remunerations schemes on the physiciansí side. The two-sided market approach is characterized by the concept of common network externality (CNE) introduced by Bardey et al. (2010). This type of externality occurs when occurs when both sides value, possibly with di§erent intensities, the same network externality. We explicitly introduce e§ort exerted by doctors. By increasing the number of medical acts (which involves a costly e§ort) the doctor can increase the quality of service o§ered to patients (over and above the level implied by the CNE). We Örst consider pure salary, capitation or fee-for-service schemes. Then, we study schemes that mix fee-for-service with either salary or capitation payments. We show that salary schemes (either pure or in combination with fee-for-service) are more patient friendly than (pure or mixed) capitations schemes. This comparison is exactly reversed on the providersíside. Quite surprisingly, patients always loose when a fee-for-service scheme is introduced (pure of mixed). This is true even though the fee-for-service is the only way to induce the providers to exert e§ort and it holds whatever the patientsívaluation of this e§ort. In other words, the increase in quality brought about by the fee-for-service is more than compensated by the increase in fees faced by patients.
format Documento de trabajo (Working Paper)
author Bardey, David
Cremer, Helmuth
Lozachmeur, Jean-Marie
author_facet Bardey, David
Cremer, Helmuth
Lozachmeur, Jean-Marie
author_sort Bardey, David
title Doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities
title_short Doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities
title_full Doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities
title_fullStr Doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities
title_full_unstemmed Doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities
title_sort doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities
publisher Universidad del Rosario
publishDate 2011
url http://repository.urosario.edu.co/handle/10336/10952
_version_ 1645141526072786944
score 11,366519