Broadway Barbara, Kalb Guyonne, Li Jinhu, Scott Anthony
Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Melbourne, VIC, Australia.
ARC Centre of Excellence for Children and Families over the Life Course, Indooroopilly, QLD, Australia.
Health Econ. 2017 Dec;26(12):e52-e66. doi: 10.1002/hec.3476. Epub 2017 Feb 20.
This paper analyses doctors' supply of after-hours care (AHC), and how it is affected by personal and family circumstances as well as the earnings structure. We use detailed survey data from a large sample of Australian General Practitioners (GPs) to estimate a structural, discrete choice model of labour supply and AHC. This allows us to jointly model GPs' decisions on the number of daytime-weekday working hours and the probability of providing AHC. We simulate GPs' labour supply responses to an increase in hourly earnings, both in a daytime-weekday setting and for AHC. GPs increase their daytime-weekday working hours if their hourly earnings in this setting increase, but only to a very small extent. GPs are somewhat more likely to provide AHC if their hourly earnings in that setting increase, but again, the effect is very small and only evident in some subgroups. Moreover, higher earnings in weekday-daytime practice reduce the probability of providing AHC, particularly for men. Increasing GPs' earnings appears to be at best relatively ineffective in encouraging increased provision of AHC and may even prove harmful if incentives are not well targeted. Copyright © 2017 John Wiley & Sons, Ltd.
本文分析了医生提供非工作时间护理(AHC)的情况,以及其如何受到个人和家庭状况以及收入结构的影响。我们使用来自大量澳大利亚全科医生(GPs)样本的详细调查数据,来估计劳动力供给和AHC的结构化离散选择模型。这使我们能够联合模拟全科医生关于工作日白天工作时长的决策以及提供AHC的概率。我们模拟了全科医生在工作日白天工作环境和AHC环境下对小时收入增加的劳动力供给反应。如果工作日白天工作环境下的小时收入增加,全科医生会增加其工作日白天的工作时长,但幅度非常小。如果在提供AHC环境下的小时收入增加,全科医生提供AHC的可能性会有所增加,但同样,这种影响非常小,且仅在某些亚组中明显。此外,工作日白天执业收入的增加会降低提供AHC的概率,对男性尤其如此。提高全科医生的收入在鼓励增加AHC提供方面似乎至多相对无效,如果激励措施目标不明确,甚至可能有害。版权所有© 2017约翰·威利父子有限公司。