1. Financial incentives and patient selection: Hospital physicians' views on cream skimming and economic management focus in Norway
- Author
-
Gjertrud Hole Kjøstolfsen, Pål E. Martinussen, Jon Magnussen, and Janusha Baheerathan
- Subjects
Motivation ,Financial stability ,Norway ,030503 health policy & services ,Health Policy ,Insurance Selection Bias ,Hospitals ,03 medical and health sciences ,Cream skimming ,0302 clinical medicine ,Incentive ,Financial incentives ,Physicians ,Economic management ,Selection (linguistics) ,Survey data collection ,Humans ,030212 general & internal medicine ,Business ,Marketing ,0305 other medical science - Abstract
This paper uses survey data to analyse physician views on the risk of cream skimming under a system with activity based financing (ABF) for hospital services. We used data from two nation-wide physician surveys. A survey undertaken in 2006 captures views following a large NPM-inspired structural reform in 2002. In contrast, a survey undertaken in 2016 captures views after a period of a higher degree of institutional and financial stability. We find that the majority of physicians believed that the 2002 reform both provided incentives for and led to more cream skimming. In 2016, however there is less consensus among physicians about the extent of cream skimming. Looking at different types of physicians we find some indications that physicians in leading positions are less likely to view cream skimming as a problem. However, there is concern that hospital management in general puts too much emphasis on economic issues.
- Published
- 2019