Institute of Health Policy and Management, Erasmus University, DR Rotterdam, The Netherlands.
Health Serv Res. 2011 Apr;46(2):510-30. doi: 10.1111/j.1475-6773.2010.01196.x. Epub 2010 Oct 28.
To effectively bargain about the price and quality of health services, health insurers need to successfully channel their enrollees. Little is known about consumer sensitivity to different channeling incentives. In particular, the impact of status quo bias, which is expected to differ between different provider types, can play a large role in insurers' channeling ability.
To examine consumer sensitivity to channeling strategies and to analyze the impact of status quo bias for different provider types.
DATA SOURCES/STUDY DESIGN: With a large-scale discrete choice experiment, we investigate the impact of channeling incentives on choices for pharmacies and general practitioners (GPs). Survey data were obtained among a representative Dutch household panel (n = 2,500).
Negative financial incentives have a two to three times larger impact on provider choice than positive ones. Positive financial incentives have a relatively small impact on GP choice, while the impact of qualitative incentives is relatively large. Status quo bias has a large impact on provider choice, which is more prominent in the case of GPs than in the case of pharmacies.
The large impact of the status quo bias makes channeling consumers away from their current providers a daunting task, particularly in the case of GPs.
为了有效地就医疗服务的价格和质量进行谈判，健康保险公司需要成功引导其参保人。对于消费者对不同引导激励措施的敏感性，人们知之甚少。特别是，预期不同提供者类型之间存在差异的现状偏见的影响，可能会在保险公司的引导能力中发挥重要作用。
研究消费者对引导策略的敏感性，并分析不同提供者类型的现状偏见的影响。
资料来源/研究设计：我们利用一项大规模的离散选择实验，调查了对药店和全科医生（GP）的引导激励措施对选择的影响。调查数据是从一个具有代表性的荷兰家庭小组（n=2500）中获得的。
负财务激励对提供者选择的影响是正财务激励的两到三倍，而正财务激励对 GP 选择的影响相对较小，而质量激励的影响则相对较大。现状偏见对提供者选择有很大的影响，在 GP 的情况下比在药店的情况下更为明显。
现状偏见的巨大影响使得将消费者从当前的提供者那里引导出来成为一项艰巨的任务，特别是在 GP 的情况下。
