IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v25y2016i8p1020-1038.html
   My bibliography  Save this article

Modelling Nonlinearities and Reference Dependence in General Practitioners' Income Preferences

Author

Listed:
  • Jon Helgheim Holte
  • Peter Sivey
  • Birgit Abelsen
  • Jan Abel Olsen

Abstract

This paper tests for the existence of nonlinearity and reference dependence in income preferences for general practitioners. Confirming the theory of reference dependent utility within the context of a discrete choice experiment, we find that losses loom larger than gains in income for Norwegian general practitioners, i.e. they value losses from their current income level around three times higher than the equivalent gains. Our results are validated by comparison with equivalent contingent valuation values for marginal willingness to pay and marginal willingness to accept compensation for changes in job characteristics. Physicians' income preferences determine the effectiveness of ‘pay for performance’ and other incentive schemes. Our results may explain the relative ineffectiveness of financial incentive schemes that rely on increasing physicians' incomes. Copyright © 2015 John Wiley & Sons, Ltd.

Suggested Citation

  • Jon Helgheim Holte & Peter Sivey & Birgit Abelsen & Jan Abel Olsen, 2016. "Modelling Nonlinearities and Reference Dependence in General Practitioners' Income Preferences," Health Economics, John Wiley & Sons, Ltd., vol. 25(8), pages 1020-1038, August.
    • Handle: RePEc:wly:hlthec:v:25:y:2016:i:8:p:1020-1038
    DOI: 10.1002/hec.3208
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3208
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.3208?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Marjon van der Pol & Shiell, Alan & Au, Flora & Johnston, David & Tough, Suzanne, 2008. "Convergent validity between a discrete choice experiment and a direct, open-ended method: Comparison of preferred attribute levels and willingness to pay estimates," Social Science & Medicine, Elsevier, vol. 67(12), pages 2043-2050, December.
    2. Masiero, Lorenzo & Hensher, David A., 2010. "Analyzing loss aversion and diminishing sensitivity in a freight transport stated choice experiment," Transportation Research Part A: Policy and Practice, Elsevier, vol. 44(5), pages 349-358, June.
    3. Mickael Bech & Dorte Gyrd‐Hansen, 2005. "Effects coding in discrete choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1079-1083, October.
    4. Flynn, Terry Nicholas & Louviere, Jordan J. & Peters, Tim J. & Coast, Joanna, 2010. "Using discrete choice experiments to understand preferences for quality of life. Variance-scale heterogeneity matters," Social Science & Medicine, Elsevier, vol. 70(12), pages 1957-1965, June.
    5. Sivey, Peter & Scott, Anthony & Witt, Julia & Joyce, Catherine & Humphreys, John, 2012. "Junior doctors’ preferences for specialty choice," Journal of Health Economics, Elsevier, vol. 31(6), pages 813-823.
    6. Scott, Anthony & Witt, Julia & Humphreys, John & Joyce, Catherine & Kalb, Guyonne & Jeon, Sung-Hee & McGrail, Matthew, 2013. "Getting doctors into the bush: General Practitioners' preferences for rural location," Social Science & Medicine, Elsevier, vol. 96(C), pages 33-44.
    7. Amos Tversky & Daniel Kahneman, 1991. "Loss Aversion in Riskless Choice: A Reference-Dependent Model," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 106(4), pages 1039-1061.
    8. Herriges, Joseph A. & Shogren, Jason F., 1996. "Starting Point Bias in Dichotomous Choice Valuation with Follow-Up Questioning," Journal of Environmental Economics and Management, Elsevier, vol. 30(1), pages 112-131, January.
    9. Vujicic, Marko & Shengelia, Bakhuti & Alfano, Marco & Thu, Ha Bui, 2011. "Physician shortages in rural Vietnam: Using a labor market approach to inform policy," Social Science & Medicine, Elsevier, vol. 73(7), pages 970-977.
    10. Esther W. de Bekker‐Grob & Mandy Ryan & Karen Gerard, 2012. "Discrete choice experiments in health economics: a review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 145-172, February.
    11. John A. Rizzo & Richard J. Zeckhauser, 2003. "Reference Incomes, Loss Aversion, and Physician Behavior," The Review of Economics and Statistics, MIT Press, vol. 85(4), pages 909-922, November.
    12. John M. Rose & Lorenzo Masiero, 2010. "A comparison of prospect theory in WTP and preference space," Quaderni della facoltà di Scienze economiche dell'Università di Lugano 1006, USI Università della Svizzera italiana.
    13. Jelke Bethlehem, 2010. "Selection Bias in Web Surveys," International Statistical Review, International Statistical Institute, vol. 78(2), pages 161-188, August.
    14. Arne Hole & Julie Kolstad, 2012. "Mixed logit estimation of willingness to pay distributions: a comparison of models in preference and WTP space using data from a health-related choice experiment," Empirical Economics, Springer, vol. 42(2), pages 445-469, April.
    15. Garrett Sonnier & Andrew Ainslie & Thomas Otter, 2007. "Heterogeneity distributions of willingness-to-pay in choice models," Quantitative Marketing and Economics (QME), Springer, vol. 5(3), pages 313-331, September.
    16. Richard D. Smith, 2003. "Construction of the contingent valuation market in health care:a critical assessment," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 609-628, August.
    17. Rie Fujisawa & Gaétan Lafortune, 2008. "The Remuneration of General Practitioners and Specialists in 14 OECD Countries: What are the Factors Influencing Variations across Countries?," OECD Health Working Papers 41, OECD Publishing.
    18. Hoyos, David, 2010. "The state of the art of environmental valuation with discrete choice experiments," Ecological Economics, Elsevier, vol. 69(8), pages 1595-1603, June.
    19. Daniel Kahneman & Amos Tversky, 2013. "Prospect Theory: An Analysis of Decision Under Risk," World Scientific Book Chapters, in: Leonard C MacLean & William T Ziemba (ed.), HANDBOOK OF THE FUNDAMENTALS OF FINANCIAL DECISION MAKING Part I, chapter 6, pages 99-127, World Scientific Publishing Co. Pte. Ltd..
    20. Kahneman, Daniel & Knetsch, Jack L & Thaler, Richard H, 1990. "Experimental Tests of the Endowment Effect and the Coase Theorem," Journal of Political Economy, University of Chicago Press, vol. 98(6), pages 1325-1348, December.
    21. Pedersen, Line Bjørnskov & Kjær, Trine & Kragstrup, Jakob & Gyrd-Hansen, Dorte, 2012. "General practitioners’ preferences for the organisation of primary care: A discrete choice experiment," Health Policy, Elsevier, vol. 106(3), pages 246-256.
    22. Hess, Stephane & Rose, John M. & Hensher, David A., 2008. "Asymmetric preference formation in willingness to pay estimates in discrete choice models," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 44(5), pages 847-863, September.
    23. Hole, Arne Risa & Kolstad, Julie Riise & Gyrd-Hansen, Dorte, 2013. "Inferred vs. stated attribute non-attendance in choice experiments: A study of doctors’ prescription behaviour," Journal of Economic Behavior & Organization, Elsevier, vol. 96(C), pages 21-31.
    24. Julie Riise Kolstad, 2011. "How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 196-211, February.
    25. Bateman, Ian & Kahneman, Daniel & Munro, Alistair & Starmer, Chris & Sugden, Robert, 2005. "Testing competing models of loss aversion: an adversarial collaboration," Journal of Public Economics, Elsevier, vol. 89(8), pages 1561-1580, August.
    26. Jan Olsen & Ole Røgeberg & Knut Stavem, 2012. "What Explains Willingness to Pay for Smoking-Cessation Treatments —Addiction Level, Quit-Rate Effectiveness or the Opening Bid?," Applied Health Economics and Health Policy, Springer, vol. 10(6), pages 407-415, November.
    27. Riccardo Scarpa & Mara Thiene & Kenneth Train, 2008. "Utility in Willingness to Pay Space: A Tool to Address Confounding Random Scale Effects in Destination Choice to the Alps," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 90(4), pages 994-1010.
    28. Carthy, Trevor & Chilton, Susan & Covey, Judith & Hopkins, Lorraine & Jones-Lee, Michael & Loomes, Graham & Pidgeon, Nick & Spencer, Anne, 1998. "On the Contingent Valuation of Safety and the Safety of Contingent Valuation: Part 2--The CV/SG "Chained" Approach," Journal of Risk and Uncertainty, Springer, vol. 17(3), pages 187-213, December.
    29. Horowitz, John K. & McConnell, Kenneth E., 2002. "A Review of WTA/WTP Studies," Journal of Environmental Economics and Management, Elsevier, vol. 44(3), pages 426-447, November.
    30. Denise Bijlenga & Gouke J. Bonsel & Erwin Birnie, 2011. "Eliciting willingness to pay in obstetrics: comparing a direct and an indirect valuation method for complex health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1392-1406, November.
    31. Mandy Ryan & Karen Gerard & Gillian Currie, 2012. "Using Discrete Choice Experiments in Health Economics," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 41, Edward Elgar Publishing.
    32. Scarpa, R. & Thiene, M. & Train, K., 2008. "Appendix to Utility in WTP space: a tool to address confounding random scale effects in destination choice to the Alps," American Journal of Agricultural Economics APPENDICES, Agricultural and Applied Economics Association, vol. 90(4), pages 1-9, January.
    33. Scott, Anthony, 2001. "Eliciting GPs' preferences for pecuniary and non-pecuniary job characteristics," Journal of Health Economics, Elsevier, vol. 20(3), pages 329-347, May.
    34. Frank Eijkenaar, 2013. "Key issues in the design of pay for performance programs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 117-131, February.
    35. Terence Chai Cheng & Anthony Scott & Sung‐Hee Jeon & Guyonne Kalb & John Humphreys & Catherine Joyce, 2012. "What Factors Influence The Earnings Of General Practitioners And Medical Specialists? Evidence From The Medicine In Australia: Balancing Employment And Life Survey," Health Economics, John Wiley & Sons, Ltd., vol. 21(11), pages 1300-1317, November.
    36. Denzil G. Fiebig & Michael P. Keane & Jordan Louviere & Nada Wasi, 2010. "The Generalized Multinomial Logit Model: Accounting for Scale and Coefficient Heterogeneity," Marketing Science, INFORMS, vol. 29(3), pages 393-421, 05-06.
    37. McIntosh, E. & Ryan, M., 2002. "Using discrete choice experiments to derive welfare estimates for the provision of elective surgery: Implications of discontinuous preferences," Journal of Economic Psychology, Elsevier, vol. 23(3), pages 367-382, June.
    38. Bobinac, Ana & van Exel, N. Job A. & Rutten, Frans F.H. & Brouwer, Werner B.F., 2012. "GET MORE, PAY MORE? An elaborate test of construct validity of willingness to pay per QALY estimates obtained through contingent valuation," Journal of Health Economics, Elsevier, vol. 31(1), pages 158-168.
    39. Ulla Slothuus Skjoldborg & Dorte Gyrd‐Hansen, 2003. "Conjoint analysis. The cost variable: an Achilles' heel?," Health Economics, John Wiley & Sons, Ltd., vol. 12(6), pages 479-491, June.
    40. Beattie, Jane & Covey, Judith & Dolan, Paul & Hopkins, Lorraine & Jones-Lee, Michael & Loomes, Graham & Pidgeon, Nick & Robinson, Angela & Spencer, Anne, 1998. "On the Contingent Valuation of Safety and the Safety of Contingent Valuation: Part 1--Caveat Investigator," Journal of Risk and Uncertainty, Springer, vol. 17(1), pages 5-25, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Scott, Anthony & Witt, Julia, 2020. "Loss aversion, reference dependence and diminishing sensitivity in choice experiments," Journal of choice modelling, Elsevier, vol. 37(C).
    2. Buckell, John & White, Justin S. & Shang, Ce, 2020. "Can incentive-compatibility reduce hypothetical bias in smokers’ experimental choice behavior? A randomized discrete choice experiment," Journal of choice modelling, Elsevier, vol. 37(C).
    3. Pestana, Joana & Frutuoso, João & Costa, Eduardo & Fonseca, Filipa, 2024. "Heterogeneity in physician's job preferences in a dual practice context – Evidence from a DCE," Social Science & Medicine, Elsevier, vol. 343(C).
    4. Thai, Thao & Lancsar, Emily & Spinks, Jean & Freeman, Christopher & Chen, Gang, 2024. "Understanding Australian pharmacy degree holders’ job preferences through the lens of motivation-hygiene theory," Social Science & Medicine, Elsevier, vol. 348(C).
    5. Schulz, Rainer & Watson, Verity & Wersing, Martin, 2023. "Teleworking and housing demand," Regional Science and Urban Economics, Elsevier, vol. 101(C).
    6. Ge Ge & Geir Godager & Jian Wang, 2022. "Exploring physician agency under demand‐side cost sharing—An experimental approach," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1202-1227, June.
    7. Ge, Ge & Godager, Geir, 2021. "Predicting strategic medical choices: An application of a quantal response equilibrium choice model," Journal of choice modelling, Elsevier, vol. 39(C).
    8. Arthur E. Attema & Marieke Krol & Job Exel & Werner B. F. Brouwer, 2018. "New findings from the time trade-off for income approach to elicit willingness to pay for a quality adjusted life year," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 277-291, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Holte, Jon Helgheim & Kjaer, Trine & Abelsen, Birgit & Olsen, Jan Abel, 2015. "The impact of pecuniary and non-pecuniary incentives for attracting young doctors to rural general practice," Social Science & Medicine, Elsevier, vol. 128(C), pages 1-9.
    2. John M. Rose & Lorenzo Masiero, 2010. "A comparison of prospect theory in WTP and preference space," Quaderni della facoltà di Scienze economiche dell'Università di Lugano 1006, USI Università della Svizzera italiana.
    3. Robert J. Johnston & Kevin J. Boyle & Wiktor (Vic) Adamowicz & Jeff Bennett & Roy Brouwer & Trudy Ann Cameron & W. Michael Hanemann & Nick Hanley & Mandy Ryan & Riccardo Scarpa & Roger Tourangeau & Ch, 2017. "Contemporary Guidance for Stated Preference Studies," Journal of the Association of Environmental and Resource Economists, University of Chicago Press, vol. 4(2), pages 319-405.
    4. Scott, Anthony & Witt, Julia, 2020. "Loss aversion, reference dependence and diminishing sensitivity in choice experiments," Journal of choice modelling, Elsevier, vol. 37(C).
    5. Scott, Anthony & Witt, Julia & Humphreys, John & Joyce, Catherine & Kalb, Guyonne & Jeon, Sung-Hee & McGrail, Matthew, 2013. "Getting doctors into the bush: General Practitioners' preferences for rural location," Social Science & Medicine, Elsevier, vol. 96(C), pages 33-44.
    6. Riise, Julie & Hole, Arne Risa & Gyrd-Hansen, Dorte & Skåtun, Diane, 2016. "GPs' implicit prioritization through clinical choices – evidence from three national health services," Journal of Health Economics, Elsevier, vol. 49(C), pages 169-183.
    7. Mandeville, Kate L. & Ulaya, Godwin & Lagarde, Mylène & Muula, Adamson S. & Dzowela, Titha & Hanson, Kara, 2016. "The use of specialty training to retain doctors in Malawi: A discrete choice experiment," Social Science & Medicine, Elsevier, vol. 169(C), pages 109-118.
    8. Pestana, Joana & Frutuoso, João & Costa, Eduardo & Fonseca, Filipa, 2024. "Heterogeneity in physician's job preferences in a dual practice context – Evidence from a DCE," Social Science & Medicine, Elsevier, vol. 343(C).
    9. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    10. Anthony Scott & Peter Sivey, 2022. "Motivation and competition in health care," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1695-1712, August.
    11. Haghani, Milad & Bliemer, Michiel C.J. & Hensher, David A., 2021. "The landscape of econometric discrete choice modelling research," Journal of choice modelling, Elsevier, vol. 40(C).
    12. Emily Lancsar & Peter Burge, 2014. "Choice modelling research in health economics," Chapters, in: Stephane Hess & Andrew Daly (ed.), Handbook of Choice Modelling, chapter 28, pages 675-687, Edward Elgar Publishing.
    13. Juutinen, Artti & Kosenius, Anna-Kaisa & Ovaskainen, Ville, 2014. "Estimating the benefits of recreation-oriented management in state-owned commercial forests in Finland: A choice experiment," Journal of Forest Economics, Elsevier, vol. 20(4), pages 396-412.
    14. Pedro Ramos & Hélio Alves & Paulo Guimarães & Maria A. Ferreira, 2017. "Junior doctors’ medical specialty and practice location choice: simulating policies to overcome regional inequalities," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(8), pages 1013-1030, November.
    15. Lorenzo Masiero & David Hensher, 2011. "Shift of reference point and implications on behavioral reaction to gains and losses," Transportation, Springer, vol. 38(2), pages 249-271, March.
    16. Zander, Kerstin K. & Signorello, Giovanni & De Salvo, Maria & Gandini, Gustavo & Drucker, Adam G., 2013. "Assessing the total economic value of threatened livestock breeds in Italy: Implications for conservation policy," Ecological Economics, Elsevier, vol. 93(C), pages 219-229.
    17. Line Pedersen & Dorte Gyrd-Hansen, 2014. "Preference for practice: a Danish study on young doctors’ choice of general practice using a discrete choice experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(6), pages 611-621, July.
    18. Nicolas Krucien & Jonathan Sicsic & Mandy Ryan, 2019. "For better or worse? Investigating the validity of best–worst discrete choice experiments in health," Health Economics, John Wiley & Sons, Ltd., vol. 28(4), pages 572-586, April.
    19. Vogdrup-Schmidt, Mathias & Strange, Niels & Thorsen, Bo Jellesmark, 2019. "Support for Transnational Conservation in a Gain-Loss Context," Ecological Economics, Elsevier, vol. 162(C), pages 49-58.
    20. Sever, Ivan & Verbič, Miroslav & Klarić Sever, Eva, 2019. "Cost attribute in health care DCEs: Just adding another attribute or a trigger of change in the stated preferences?," Journal of choice modelling, Elsevier, vol. 32(C), pages 1-1.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:25:y:2016:i:8:p:1020-1038. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.