Heterogeneity In General Practitioner's Preferences for Quality Improvement Programs: A Choice Experiment And Policy Simulation in France

Mehdi Ammi and Christine Peyron

No 150020, Working Papers from Canadian Centre for Health Economics

Abstract: Despite increasing popularity, quality improvement programs (QIP) have had modest and variable impacts on enhancing the quality of physician practice. We investigate the heterogeneity of physicians' preferences as a potential explanation of these mixed results in France, where the national voluntary QIP - the CAPI - has been cancelled due to its unpopularity. We rely on a discrete choice experiment to elicit heterogeneity in physicians' preferences for the financial and non-financial components of QIP. Using mixed and latent class logit models, results show that the models should be used in concert to shed light on different aspects of the heterogeneity in preferences. In particular, the mixed logit demonstrates that heterogeneity in preferences is concentrated on the pay-for-performance component of the QIP, while the latent class model shows that physicians can be grouped in four homogenous groups with specific preference patterns. Using policy simulation, we compare the French CAPI with other possible QIPs, and show that the majority of the physician subgroups modelled dislike the CAPI, while favouring a QIP using only non-financial interventions. We underline the importance of modelling preference heterogeneity in designing and implementing QIPs.

Keywords: quality improvement programs; general practitioners; discrete choice experiment; mixed logit; latent class logit; policy simulation (search for similar items in EconPapers)
JEL-codes: C25 I11 I18 (search for similar items in EconPapers)
Pages: 38 pages
Date: 2015-12
New Economics Papers: this item is included in nep-dcm and nep-hea
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Published Online, December 2015

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Persistent link: https://EconPapers.repec.org/RePEc:cch:wpaper:150020

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