Does an economic incentive affect provider behavior? Evidence from a field experiment on different payment mechanisms

Aims: This study analyzed discrepancies in the quantity of medical services supplied by physicians under different payment systems for patients with different health statuses and illnesses by means of a field experiment.

Methods: Based on the laboratory experiment of Heike Hennig-Schmidt, we designed a field experiment to examine fee-for-service (FFS), capitation (CAP), and diagnosis-related group (DRG) payment systems. Medical students were replaced with 220 physicians as experimental subjects, which more closely reflected the clinical choices made by physicians in the real world. Under the three payment mechanisms, the quantity of medical services provided by physicians when they treated patients with different health statuses and illnesses were collected. Finally, relevant statistics were computed and analyzed.

Results: It was found that payment systems (sig. = 0.000) and patient health status (sig. = 0.000) had a stronger effect on physicians’ choices regarding quantity of medical services than illness types (sig. = 0.793). Additionally, under the FFS and CAP payment systems, physicians overserved patients in good and intermediate health while underserving patients in bad health. Under the DRG payment system, physicians overserved patients in good health and underserved patients in intermediate and bad health. Correspondingly, under FFS and CAP, the proportional loss of benefits was the highest for patients in bad health and the lowest for patients in good and intermediate health; while under DRGs, patients in good and intermediate health had the largest and smallest loss of benefits, respectively.

Limitations: In order to increase external effects of experiment results, we used the field experiment to replace laboratory experiment. However, the external effects still existed because of the blurring and abstraction of the parameters.

Conclusions: Medical treatment cost and price affected the quantity of medical services provided by physicians. Therefore, we proposed that a mix of payment systems could address the common interests of physicians and patients, as well as influence incentives from payment systems.     

Volatility forecasting: long memory,regime switching and heteroscedasticity

In this article, we account for the first time for long memory, regime switching and the conditional time-varying volatility of volatility (heteroscedasticity) to model and forecast market volatility using the heterogeneous autoregressive model of realized volatility (HAR-RV) and its extensions. We present several interesting and notable findings. First, existing models exhibit significant nonlinearity and clustering, which provide empirical evidence on the benefit of introducing regime switching and heteroscedasticity. Second, out-of-sample results indicate that combining regime switching and heteroscedasticity can substantially improve predictive power from a statistical viewpoint. More specifically, our proposed models generally exhibit higher forecasting accuracy. Third, these results are widely consistent across a variety of robustness tests such as different forecasting windows, forecasting models, realized measures, and stock markets. Consequently, this study sheds new light on forecasting future volatility.     

Editors’ note

Portuguese Economic Journal -     

船舶消防用水对船舶稳性影响之研究

在船舶灭火中,由于忽视消防用水对船舶稳性的影响造成船舶倾覆的事故时有发生。文中通过对船舶灭火过程中消防用水对船舶稳性所造成的影响因素进行研究和分析,提出了消除不良影响的应对措施。     

社会审计委托代理分析

本文分析了社会审计契约中委托代理关系及审计信息不对称表现及形成原因,通过建立社会审计的委托代理模型,揭示了在审计人和委托人均完全理性的假设下,委托人可以通过激励机制鼓励审计人尽最大努力完成工作。在此基础上分析了我国社会审计收费制度的不合理性、转轨经济环境下社会审计合约具有的不完全契约特性,并提出了改革的设想。     

努力营造现代物流业发展的政策环境

"十一五"规划纲要明确了现代物流的产业地位,提出了"大力发展现代物流业".温家宝总理在今年的《政府工作报告》中,再次强调发展现代物流业.现代物流业作为新兴的生产性服务业,已成为推动经济发展的加速器.     

德国光伏电价的下降历程及其对中国光伏发电产业的启示

近年来,我国大力发展光伏发电,然而目前的财政补贴和单一电价的扶持方式不足以实现其大规模发展。光伏大国——德国在2000~2011年间通过一系列政策调控,实现了光伏快速发展,同时光伏电价逐渐由50 Euro cent/kWh下降到20 Euro cent/kWh,降幅达60%,逐步接近市电价格。文章深入解析德国光伏的发展历程,利用投资与回报的分析方法,研究了德国光伏政策对装机量和光伏电价竞争性的影响,结果发现德国以清晰、有针对性的产业政策为基础,分起步、发展及调整三个阶段调整光伏电价,促使其累计装机量增加了325倍,上升至24 820 MWp。另外,德国采用全国终端用电客户分摊绿色电力成本的方式代替财政补贴,使其发展更具可持续性。借鉴德国经验,中国应该按光伏现有规模完善其电价体系,刺激光伏发展,同时,通过明朗的扶持政策增强光伏投资信心,构建稳定的投资回报预期。     

Why is free education so popular? A political economy explanation

This paper analyzes the political support for different funding regimes of education in a one‐person, one‐vote democracy. We focus the analysis on four systems that have had a preponderant presence in the political debate on education: a private system, a public system that delivers the same resources to each student (universal‐free education), a public system that intends to equalize results, and a public system that aims to maximize the output of the economy. We show that a system of universal free education is the Condorcet winner. The level of income inequality and the degree to which income distribution is skewed to the right are key factors behind this conclusion. We also show that the voting outcome of public versus private funding for education depends crucially on the type of public funding under consideration.     

计及外部性的储能系统价值测算及经济性评估

以应用在电力系统中的电储能系统为研究对象,以外部性理论为基础,构建了计及外部性的储能系统经济性测算模型,并以储能系统接入光伏电站为例,采用贴现现金流分析方法,预估储能投资成本和收益,分别从投资者角度和社会整体效益角度,来研究储能系统应用在可再生能源发电侧的经济性,并进行了盈亏平衡分析。通过盈亏平衡曲线分析了储能盈亏平衡情景,经济性分析结果显示储能系统的外部性收益占年收益比例较大。