Understanding how physicians respond to payment methods is crucial for designing effective incentives and enhancing the insurance system. Previous theoretical research has explored the effects of ...payment methods on physician behavior based on a two-level incentive path; however, empirical evidence to validate these theoretical frameworks is lacking. To address this research gap, we conducted a laboratory experiment to investigate physicians' behavioral responses to three types of internal salary incentives based on diagnosis-related-group (DRG) and fee-for-service (FFS).
A total of 150 medical students from Capital Medical University were recruited as participants. These subjects played the role of physicians in choosing the quantity of medical services for nine types of patients under three types of salary incentives-fixed wage, constant fixed wage with variable performance wage, and variable fixed wage with variable performance wage, of which performance wage referred to the payment method balance under FFS or DRG. We collected data on the quantities of medical services provided by the participants and analyzed the results using the Friedman test and the fixed effects model.
The results showed that a fixed wage level did not have a significant impact on physicians' behavior. However, the patients benefited more under the fixed wage compared to other salary incentives. In the case of a floating wage system, which consisted of a constant fixed wage and a variable performance wage from the payment method balance, an increase in performance wage led to a decrease in physicians' service provision under DRG but an increase under FFS. Consequently, this resulted in a decrease in patient benefit. When the salary level remained constant, but the composition of the salary varied, physicians' behavior changed slightly under FFS but not significantly under DRG. Additionally, patient benefits decreased as the ratio of performance wages increased under FFS.
While using payment method balance as physicians' salary may be effective in transferring incentives of payment methods to physicians through internal compensation frameworks, it should be used with caution, particularly when the measurement standard of care is imperfect.
The system of higher education in Russia, as in many other countries, is in the midst of reforms related to the global trends of globalization and transformation to a knowledge economy. In order to ...successfully respond to these global challenges, it is necessary to improve the quality of the university sector and rethink the role of professors in enhancing academic productivity. A 20-year period of recession after the collapse of the Soviet Union has led to a diversification of universities and teachers and resulted in both a sharp fall in academic salaries and a decline in the attractiveness of the academic profession. Since the professoriate constitutes the main source of academic productivity, this article assesses the consequences of the decline in the academic sector before the start of major reforms of academic salaries. Using the data from the 'The Changing Academic Profession' project (CAP-Russia 2012 subsample), we identified and evaluated the activities of the professoriate that determine the income of university staff. The results show that, in general, the number of publications positively affected academic salaries, but for certain indicators of research activity, the effects are ambiguous. Administrative duties are important for academic salaries, with a positive effect ranging from 15 to 51%. Seniority also has a positive impact on a professor's salary. The most consistent results in the pre-reform period were obtained for National research universities (NRUs), where academic salaries are determined by research activity (articles in academic journals) and administrative duties. Salaries rise with seniority, which corresponds to the human capital theory (as well as alternative theories). Salaries in NRUs also reflect gender equality. The results of the study can be used to assess the consequences of the recession in the academic sector in Russia and as a baseline for analyzing current reforms in universities.
BackgroundSocial welfare policies such as the minimum wage can affect population health, though the impact may differ by the level of unemployment experienced by society at a given time.MethodsWe ran ...difference-in-differences models using monthly data from all 50 states and Washington, DC from 1990 to 2015. We used educational attainment to define treatment and control groups. The exposure was the difference between state and federal minimum wage in US$2015, defined both by the date the state law became effective and lagged by 1 year. Models included state and year fixed effects, and additional state-level covariates to account for state-specific time-varying confounding. We assessed effect modification by the state-level unemployment rate, and estimated predicted suicide counts under different minimum wage scenarios.ResultsThe effect of a US$1 increase in the minimum wage ranged from a 3.4% decrease (95% CI 0.4 to 6.4) to a 5.9% decrease (95% CI 1.4 to 10.2) in the suicide rate among adults aged 18–64 years with a high school education or less. We detected significant effect modification by unemployment rate, with the largest effects of minimum wage on reducing suicides observed at higher unemployment levels.ConclusionMinimum wage increases appear to reduce the suicide rate among those with a high school education or less, and may reduce disparities between socioeconomic groups. Effects appear greatest during periods of high unemployment.
The factors that account for the differences in the economic productivity of urban areas have remained difficult to measure and identify unambiguously. Here we show that a microscopic derivation of ...urban scaling relations for economic quantities vs. population, obtained from the consideration of social and infrastructural properties common to all cities, implies an effective model of economic output in the form of a Cobb-Douglas type production function. As a result we derive a new expression for the Total Factor Productivity (TFP) of urban areas, which is the standard measure of economic productivity per unit of aggregate production factors (labor and capital). Using these results we empirically demonstrate that there is a systematic dependence of urban productivity on city population size, resulting from the mismatch between the size dependence of wages and labor, so that in contemporary US cities productivity increases by about 11% with each doubling of their population. Moreover, deviations from the average scale dependence of economic output, capturing the effect of local factors, including history and other local contingencies, also manifest surprising regularities. Although, productivity is maximized by the combination of high wages and low labor input, high productivity cities show invariably high wages and high levels of employment relative to their size expectation. Conversely, low productivity cities show both low wages and employment. These results shed new light on the microscopic processes that underlie urban economic productivity, explain the emergence of effective aggregate urban economic output models in terms of labor and capital inputs and may inform the development of economic theory related to growth.
In America today, a public official's lawful income consists of a salary. But until a century ago, the law frequently provided for officials to make money on a profit-seeking basis. Prosecutors won a ...fee for each defendant convicted. Tax collectors received a percentage of each evasion uncovered. Naval officers took a reward for each ship sunk. Numerous other officers were likewise paid for "performance." This book is the first to document the American government's for-profit past, to discover how profit-seeking defined officialdom's relationship to the citizenry, and to explain how lawmakers-by ultimately banishing the profit motive in favor of the salary-transformed that relationship forever.
Research on academic pay finds an unexplained gender pay gap that has not fully dissolved over time and that appears to increase with years of experience. In this study, I consider how role congruity ...bias contributes to this pay gap. Bias is more likely to manifest in a context where there is some ambiguity about performance and where stereotypes are stronger. I predict that bias in the attribution of credit for coauthored research leads to lower returns to research for female professors. To test this prediction, I use a sample of Canadian faculty in accounting, where research is typically coauthored, where females are underrepresented at the most senior ranks, and where many universities evaluate merit in research, teaching, and service to determine salary increases. In regressions of salary on individual and institutional determinants of salary, I find that women earn marginally less than men. However, the pay gap is only evident for women who publish in a selective list of journals; for the subset of faculty with no publications from this list, there are no significant differences in salary. For researching faculty, the pay gap relates specifically to research productivity. While women publish less on average than men, the returns to their research are also lower. In particular, the relation between the individual's research ranking and salary is significantly lower for women who publish a higher proportion of their work with men, than for all other faculty. Additional analysis of salary and coauthor patterns confirms that women receive significantly less credit for coauthored articles they publish with men than those they publish with other women but that no similar variations in reward are evident for men across publishing patterns. These findings suggest bias in the attribution of credit for coauthored research in the determination of salary, consistent with role congruity theory, and provide an important potential explanation for why salaries for women vary systematically from those of men even after considering productivity. Providing lower rewards for equal work represents a continuing ethical issue in academe and compounds the challenges women already facing in the profession.
The singular focus of public debate on the "top 1 percent" of households overlooks the component of earnings inequality that is arguably most consequential for the "other 99 percent" of citizens: the ...dramatic growth in the wage premium associated with higher education and cognitive ability. This Review documents the central role of both the supply and demand for skills in shaping inequality, discusses why skill demands have persistently risen in industrialized countries, and considers the economic value of inequality alongside its potential social costs. I conclude by highlighting the constructive role for public policy in fostering skills formation and preserving economic mobility.
This study investigates whether the completion of an optional 'sandwich' work placement enhances graduate starting salaries. We use a variety of multivariate regression techniques to investigate this ...issue and find that the graduate starting salaries of students who took professional work placements were significantly higher by £1686 ($2105) compared to non-placement students. We make a methodological contribution to the literature by controlling for self-selection bias. That is, our analysis takes into consideration that certain students self-select in to work placements and that they would have had higher starting salaries regardless of whether choosing to take a work placement. Additional insights showed that placements may be detrimental in terms of alleviating class and gender pay inequality but may have helped to reduce ethnic pay inequality. Our results have important implications for graduate employability and its impact on wider society.
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