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A Stochastic Game Analysis of Incentives and Behavioral Barriers in Chronic Disease Management

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  • Hui Zhang

    (The Center for Health and the Social Sciences, The University of Chicago, Chicago, Illinois 60637)

  • Christian Wernz

    (Department of Health Administration, Virginia Commonwealth University, Richmond, Virginia 23298)

  • Danny R. Hughes

    (Harvey L. Neiman Health Policy Institute, Reston, Virginia 20191; School of Economics, Georgia Institute of Technology, Atlanta, Georgia 30332)

Abstract

Chronic diseases can be prevented or mitigated by changing the behavior of patients and physicians. Incentives are one of the mechanisms to motivate such change. We present a two-player, multiperiod stochastic game model in which patients and primary care physicians jointly decide on chronic disease management activities. The model accounts for the decisions of patients regarding primary care engagement and lifestyle, as well as physicians’ choice of effort spent in clinical encounters. We capture the behavioral aspects of patients’ decisions by incorporating the health belief model. The physician-patient interaction is modeled as a general-sum stochastic game with switching control structure. A nonlinear programming (NLP) approach is used to find the agents’ optimal strategies. Using data on coronary heart disease, we provide a numerical example that quantifies how behavioral barriers and incentives affect patients’ and physicians’ decisions. Our results provide insights for health policy makers on how to design incentive mechanisms that contribute to more effective chronic disease management.

Suggested Citation

  • Hui Zhang & Christian Wernz & Danny R. Hughes, 2018. "A Stochastic Game Analysis of Incentives and Behavioral Barriers in Chronic Disease Management," Service Science, INFORMS, vol. 10(3), pages 302-319, September.
    • Handle: RePEc:inm:orserv:v:10:y:2018:i:3:p:302-319
    DOI: serv.2018.0211
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    References listed on IDEAS

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    Cited by:

    1. Lisa M. Maillart & Maria E. Mayorga, 2018. "Introduction to the Special Issue on Advancing Health Services," Service Science, INFORMS, vol. 10(3), pages 1-1, September.
    2. Christian Wernz & Yongjia Song & Danny R. Hughes, 2021. "How hospitals can improve their public quality metrics: a decision-theoretic model," Health Care Management Science, Springer, vol. 24(4), pages 702-715, December.
    3. Fainman, Emily Zhu & Kucukyazici, Beste, 2020. "Design of financial incentives and payment schemes in healthcare systems: A review," Socio-Economic Planning Sciences, Elsevier, vol. 72(C).

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