绩效支付中的收益与损失:来自美国调查调查的陈述偏好证据
Justin G Trogdon1,2, Aveena Khanderia1, Kathryn Brignole2
1Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
PloS one
|February 10, 2025
概括
提高人类乳头瘤病毒 (HPV) 疫苗接种率的绩效支付激励措施被发现更有效,因为损失大于收益. 较小的财政罚款比同等奖金更能激励员工.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 行为经济学是一种行为经济学.
- 公共卫生 公共卫生
背景情况:
- 按绩效支付 (P4P) 激励措施,利用奖金 (收益) 或处罚 (损失),用于影响医疗保健提供者的行为.
- 经济理论表明,个人对潜在的损失比同等收益更敏感,这一原则被称为损失厌恶.
研究的目的:
- 确定激励初级保健提供者和临床工作人员提高人类乳头瘤病毒 (HPV) 疫苗接种率所需的最低财务激励 (收益或损失).
- 为了比较基于收益的与基于损失的P4P设计对HPV疫苗接种工作的激励影响.
主要方法:
- 在2022年,美国对2527名初级保健临床工作人员进行了一项全国性调查,重点关注那些为9-12岁儿童注射HPV疫苗的人.
- 参与者被随机分配,以评估假设的P4P激励设计:实现未指定的HPV疫苗接种目标的奖金或未达到目标的处罚.
- 衡量的主要结果是自我报告的最低激励金额 (美元),这将刺激提高HPV疫苗接种率的努力,分析对各种提供者和诊所特征进行调整.
主要成果:
- 激励努力所需的平均激励在损失P4P设计 ($1,185) 与收益P4P设计 ($2,155) 相比,在损失P4P设计 ($1,185) 中显著较低,调整后的差异为$967 (p < 0.001).
- 根据农村地区或之前的激励措施经验,没有观察到激励影响的显著差异.
- 医生报告说,P4P设计的收益和损失之间所需的激励金额的最大差异是医生.
结论:
- 声明偏好数据表明,增加HPV疫苗接种率的P4P激励措施可能被设计成损失而不是收益,需要大约一半的财政支出.
- 这表明,利用损失厌恶可能是一种更具成本效益的策略,用于改善初级保健机构的疫苗接种覆盖率.
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