Leonard Kenneth L
University of Maryland, College Park, MD 20742, USA.
J Health Econ. 2008 Mar;27(2):444-59. doi: 10.1016/j.jhealeco.2007.07.004. Epub 2007 Nov 29.
We introduce a new instrument to evaluate the impact of behavior on outcomes when the behavior may be a function of unobserved variables that also affect outcomes. The instrument is introduced through a test of patient sensitivity to increases in the quality of care provided by doctors. We utilize the Hawthorne effect, in which the very presence of a research team causes doctors to provide measurably superior quality care for any type of patient to show that patients respond to this increased quality and are more likely to be very satisfied. Using the Hawthorne effect as an instrument allows us to examine the responsiveness of satisfaction to improvements in quality despite the fact that patient satisfaction is subjective and jointly produced with quality during the course of a consultation.
当行为可能是影响结果的未观察变量的函数时，我们引入一种新工具来评估行为对结果的影响。该工具是通过测试患者对医生提供的护理质量提高的敏感性来引入的。我们利用霍桑效应，即研究团队的存在会使医生为任何类型的患者提供明显更高质量的护理，以表明患者对这种提高的质量做出反应，并且更有可能非常满意。将霍桑效应用作一种工具，使我们能够检验满意度对质量改善的反应能力，尽管患者满意度是主观的，并且在会诊过程中与质量共同产生。
