School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Kunshan Integrated TCM and Western Medicine Hospital, Kunshan 215332, China.
Int J Environ Res Public Health. 2022 Oct 11;19(20):13075. doi: 10.3390/ijerph192013075.
How monetary incentives promote physicians' job performance in terms of patient satisfaction has been widely discussed. The incentive dilemma debate concerns whether monetary incentives reduce physicians' intrinsic motivation at work and even lead to moral hazard. This study investigated monetary incentive policies in a hospital and analyzed how monetary incentives affect performance and behavior. By means of income composition grouping, a treatment group and control group were established, and the identification of the effect on performance was implemented using the difference-in-difference (DiD) method. The mechanism analysis was implemented using the event-study approach (ESA) and path analysis. The study found that (1) monetary incentives promote physicians to improve patient satisfaction, and the average effect is a two-point increment ( < 0.0001); (2) the effects are short-term; and (3) in contrast to many criticisms, the improvement in patient satisfaction was mainly from the effort in working during the monetary incentive policy. The results of this study contribute empirical evidence regarding the effects of monetary incentives and their mechanism and can help hospital management formulate incentive plans.
关于金钱激励如何提高医生在患者满意度方面的工作表现,已经有了广泛的讨论。激励困境的争论涉及到金钱激励是否会降低医生工作中的内在动机,甚至导致道德风险。本研究调查了医院的金钱激励政策,并分析了金钱激励如何影响绩效和行为。通过收入构成分组,建立了实验组和对照组,并使用双重差分(Difference-in-Difference,DiD)方法来识别对绩效的影响。使用事件研究法(Event-Study Approach,ESA)和路径分析进行机制分析。研究发现:(1)金钱激励促使医生提高患者满意度,平均效果为增加两点(<0.0001);(2)效果是短期的;(3)与许多批评意见相反,患者满意度的提高主要来自于实施金钱激励政策期间的工作努力。本研究的结果为金钱激励的效果及其机制提供了经验证据,有助于医院管理制定激励计划。