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医疗资源稀缺与优先决策:一项具有异质患者类型的实验室实验

Resource scarcity and prioritization decisions in medical care: A lab experiment with heterogeneous patient types.

机构信息

Faculty of Economics and Business Administration, University of Duisburg-Essen, Essen, Germany.

CINCH-Health Economics Research Center, University of Duisburg-Essen, Essen, Germany.

出版信息

Health Econ. 2021 Feb;30(2):470-477. doi: 10.1002/hec.4192. Epub 2020 Nov 13.

Abstract

During the COVID-19 pandemic, health care systems around the world have received additional funding, while at other times, financial support has been lowered to consolidate public spending. Such budget changes likely affect provision behavior in health care. We study how different degrees of resource scarcity affect medical service provision and, in consequence, patients' health. In a controlled lab environment, physicians are paid by capitation and allocate limited resources to several patients. This implies a trade-off between physicians' profits and patients' health benefits. We vary levels of resource scarcity and patient characteristics systematically and observe that most subjects in the role of physician devote a relatively stable share of budget to patient treatment, implying that they provide fewer services when they face more severe budget constraints. Average patient benefits decrease in proportion to physician budgets. The majority of subjects chooses an allocation that leads to equal patient benefits as opposed to allocating resources efficiently.

摘要

在 COVID-19 大流行期间,世界各地的医疗体系获得了额外的资金,而在其他时候,财政支持则有所减少,以整合公共支出。这种预算变化可能会影响医疗保健的提供行为。我们研究了不同程度的资源匮乏如何影响医疗服务的提供,并进而影响患者的健康。在一个受控的实验室环境中,医生按人头付费,并将有限的资源分配给几个病人。这意味着医生的利润和病人的健康收益之间存在权衡。我们系统地改变资源匮乏程度和病人特征的水平,并观察到扮演医生角色的大多数人将相对稳定的预算份额用于病人治疗,这意味着当他们面临更严重的预算限制时,他们提供的服务会减少。平均患者受益与医生预算成比例减少。大多数人选择的分配方案会导致患者受益均等,而不是有效地分配资源。

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