Market Conditions and General Practitioners’ Referrals

We study how market conditions influence referrals of patients by general practitioners (GPs). We set up a model of GP referral for the Norwegian health care system, where a GP receives capitation payment based on the number of patients in his practice, as well as fee-for-service reimbursements. A GP may accept new patients or close the practice to new patients. We model GPs as partially altruistic, and compete for patients. We show that a GP operating in a more competitive market refers more. To retain patients in his practice, a GP satisfies patients’ requests for referrals. Furthermore, a GP who faces patient shortage will refer more often than a GP who has enough patients. More referrals may add to profits from future treatments. Using data of radiology referrals by GPs in Norway, we test and confirm our theory.Physician; service motive; profit motive; referral; radiology

Product differentiation with multiple qualities

We study subgame-perfect equilibria of the classical quality-price, multistage game of vertical product differentiation. Each of two firms can choose the levels of an arbitrary number of qualities. Consumers’ valuations are drawn from independent and general distributions. The unit cost of production is increasing and convex in qualities. We characterize equilibrium prices, and the effects of qualities on the rival’s equilibrium price in the general model. Equilibrium qualities depend on what we call the Spence and price-reaction effects. For any equilibrium, we characterize conditions for quality differentiation.Accepted manuscrip

Information acquisition, referral, and organization

Each of two experts may provide a service to a client. Experts' cost comparative advantage depends on an unknown state, but an expert may exert effort to get a private signal about it. In a market, an expert may refer the client to the other for a fee. In equilibrium, only one expert exerts effort and refers, and the equilibrium allocation is inefficient. Referral efficiency can be restored when experts form an organization, in which a referring expert must bear the referred expert's cost. However, the referred expert shirks from work effort because of the lack of cost responsibility.2018-11-1

Changing preferences: an experiment and estimation of market-incentive effects on altruism

This paper studies how altruistic preferences are changed by markets and incentives. We conduct a laboratory experiment in a within-subject design. Subjects are asked to choose health care qualities for hypothetical patients in monopoly, duopoly, and quadropoly. Prices, costs, and patient benefits are experimental incentive parameters. In monopoly, subjects choose quality to tradeoff between profits and altruistic patient benefits. In duopoly and quadropoly, we model subjects playing a simultaneous-move game. Each subject is uncertain about an opponent's altruism, and competes for patients by choosing qualities. Bayes-Nash equilibria describe subjects' quality decisions as functions of altruism. Using a nonparametric method, we estimate the population altruism distributions from Bayes-Nash equilibrium qualities in different markets and incentive configurations. Markets tend to reduce altruism, although duopoly and quadropoly equilibrium qualities are much higher than those in monopoly. Although markets crowd out altruism, the disciplinary powers of market competition are stronger. Counterfactuals confirm markets change preferences.Accepted manuscrip

Service motives and profit incentives among physicans

We model physicians as health care professionals who care about their services and monetary rewards. These preferences are heterogeneous. Different physicians trade off the monetary and service motives differently, and therefore respond differently to incentive schemes. Our model is set up for the Norwegian health care system. First, each private practice physician has a patient list, which may have more or less patients than he desires. The physician is paid a fee-for-service reimbursement and a capitation per listed patient. Second, a municipality may obligate the physician to perform 7.5 hours per week of community services. Our data are on an unbalanced panel of 435 physicians, with 412 physicians for the year 2002, and 400 for 2004. A physician’s amount of gross wealth and gross debt in previous periods are used as proxy for preferences for community service. First, for the current period, accumulated wealth and debt are predetermined. Second, wealth and debt capture lifestyle preferences because they correlate with the planned future income and spending. The main results show that both gross debt and gross wealth have negative effects on physicians’ supply of community health services. Gross debt and wealth have no effect on fee-for-service income per listed person in the physician’s practice, and positive effects on the total income from fee-for-service; hence, the higher income from fee-for-service is due to a longer patient list. Patient shortage has no significant effect on physicians’ supply of community services, a positive effect on the fee-for-service income per listed person, and no effect on the total income from fee-for service. These results confirm physician preference heterogeneity.physicians; incentive schemes; patient list; fee-for-service reimbursement; capitation per listed patient

Knowledge sharing and social media: Altruism, perceived online attachment motivation, and perceived online relationship commitment

Social media, such as Facebook and Twitter, have become extremely popular. Facebook, for example, has more than a billion registered users and thousands of millions of units of information are shared every day, including short phrases, articles, photos, and audio and video clips. However, only a tiny proportion of these sharing units trigger any type of knowledge exchange that is ultimately beneficial to the users. This study draws on the theory of belonging and the intrinsic motivation of altruism to explore the factors contributing to knowledge sharing behavior. Using a survey of 299 high school students applying for university after the release of the public examination results, we find that perceived online attachment motivation (β = 0.31, p \u3c 0.001) and perceived online relationship commitment (β = 0.49, p \u3c 0.001) have positive, direct, and significant effects on online knowledge sharing (R2 0.568). Moreover, when introduced into the model, altruism has a direct and significant effect on online knowledge sharing (β = 0.46, p \u3c 0.001) and the total variance explained by the extended model increases to 64.9%. The implications of the findings are discussed

Product Differentiation with Multiple Qualities

We study subgame-perfect equilibria of the classical quality-price, multistage game of vertical product differentiation. Each firm can choose the levels of an arbitrary number of qualities. Consumers’ valuations are drawn from independent and general distributions. The unit cost of production is increasing and convex in qualities. We characterize equilibrium prices, and the equilibrium effects of qualities on the rival’s price in the general model. We present necessary and sufficient conditions for equilibrium differentiation in any of the qualities