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货币激励对在线医疗咨询平台中医师亲社会行为的影响:来自中国的证据。

The Impact of Monetary Incentives on Physician Prosocial Behavior in Online Medical Consulting Platforms: Evidence From China.

作者信息

Jing Dong, Jin Yu, Liu Jianwei

机构信息

Key Laboratory of Interactive Media Design and Equipment Service Innovation, Harbin Institute of Technology, Harbin, China.

School of Management, Harbin Institute of Technology, Harbin, China.

出版信息

J Med Internet Res. 2019 Jul 26;21(7):e14685. doi: 10.2196/14685.

Abstract

BACKGROUND

In online medical consulting platforms, physicians can get both economic and social returns by offering online medical services, such as answering questions or sharing health care knowledge with patients. Physicians' online prosocial behavior could bring many benefits to the health care industry. Monetary incentives could encourage physicians to engage more in online medical communities. However, little research has studied the impact of monetary incentives on physician prosocial behavior and the heterogeneity of this effect.

OBJECTIVE

This study aims to explore the effects of monetary incentives on physician prosocial behavior and investigate the moderation effects of self-recognition and recognition from others of physician competence.

METHODS

This study was a fixed-effect specification-regression model based on a difference-in-differences design with robust standard errors clustered at the physician level using monthly panel data. It included 26,543 physicians in 3851 hospitals over 133 months (November 2006-December 2017) from a leading online health care platform in China. We used the pricing strategy of physicians and satisfaction levels to measure their own and patients' degree of recognition, respectively. Physicians' prosocial behavior was measured by free services offered.

RESULTS

The introduction of monetary incentives had a positive effect on physician prosocial behavior (β=1.057, P<.01). Higher self-recognition and others' recognition level of physician competence increased this promotion effect (γ=0.275, P<.01 and γ=0.325, P<.01).

CONCLUSIONS

This study explored the positive effect of the introduction of monetary incentives on physician prosocial behavior. We found this effect was enhanced for physicians with a high level of self-recognition and others' recognition of their competence. We provide evidence of the effect of monetary incentives on physicians' prosocial behaviors in the telemedicine markets and insight for relevant stakeholders into how to design an effective incentive mechanism to improve physicians' prosocial engagements.

摘要

背景

在在线医疗咨询平台上,医生通过提供在线医疗服务,如回答问题或与患者分享医疗保健知识,可以获得经济和社会回报。医生的在线亲社会行为能给医疗行业带来诸多益处。金钱激励可能会促使医生更多地参与在线医疗社区。然而,鲜有研究探讨金钱激励对医生亲社会行为的影响以及这种影响的异质性。

目的

本研究旨在探讨金钱激励对医生亲社会行为的影响,并考察医生能力的自我认知和他人认可对这种影响的调节作用。

方法

本研究基于双重差分设计,采用固定效应规格回归模型,使用稳健标准误,并在医生层面聚类,数据为中国一家领先在线医疗平台在2006年11月至2017年12月的133个月期间,3851家医院的26543名医生的月度面板数据。我们分别用医生的定价策略和满意度水平来衡量他们自己以及患者的认可程度。医生的亲社会行为通过提供的免费服务来衡量。

结果

引入金钱激励对医生亲社会行为有积极影响(β=1.057,P<0.01)。医生能力的自我认知和他人认可水平越高,这种促进作用越强(γ=0.275,P<0.01;γ=0.325,P<0.01)。

结论

本研究探讨了引入金钱激励对医生亲社会行为的积极影响。我们发现,对于自我认知和他人对其能力认可程度较高者,这种影响会增强。我们为远程医疗市场中金钱激励对医生亲社会行为的影响提供了证据,并为相关利益相关者提供了如何设计有效激励机制以提高医生亲社会参与度的见解。

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