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Physicians’ Responses to Time Pressure: Experimental Evidence on Treatment Quality and Documentation Behaviour

Author

Listed:
  • Claudia Soucek

    (Heinrich-Heine-University Duesseldorf - Institute for Health Services Research and Health Economics, Moorenstr. 5, 40225 Duesseldorf, Germany)

  • Tommaso Reggiani

    (Cardiff Business School, Cardiff University, Cardiff, United Kingdom; Masaryk University, Brno, Czechia; IZA, Bonn, Germany)

  • Nadja Kairies-Schwarz

    (Heinrich-Heine-University Duesseldorf - Institute for Health Services Research and Health Economics, Moorenstr. 5, 40225 Duesseldorf, Germany)

Abstract

Background. In hospitals, decisions are often made under time pressure. There is, however, little evidence on how time pressure affects the quality of treatment and the documentation behavior of physicians. Setting. We implemented a controlled laboratory experiment with a healthcare framing in which international medical students in the Czech Republic treated patients in the role of hospital physicians. We varied the presence of time pressure and a documentation task. Results. We observed worse treatment quality when individuals were faced with a combination of a documentation task and time pressure. In line with the concept of the speed-accuracy trade-off, we showed that quality changes are likely driven by less accuracy. Finally, we showed that while documentation quality was relatively high overall, time pressure significantly lowered the latter leading to a higher hypothetical profit loss for the hospital. Conclusions. Our results suggest that policy reforms aimed at increasing staffing and promoting novel technologies that facilitate physicians' treatment decisions and support their documentation work in the hospital sector might be promising means of improving the treatment quality and reducing inefficiencies potentially caused by documentation errors.

Suggested Citation

  • Claudia Soucek & Tommaso Reggiani & Nadja Kairies-Schwarz, 2025. "Physicians’ Responses to Time Pressure: Experimental Evidence on Treatment Quality and Documentation Behaviour," MUNI ECON Working Papers 2025-01, Masaryk University.
  • Handle: RePEc:mub:wpaper:2025-01
    DOI: 10.5817/WP_MUNI_ECON_2025-01
    Note: License: CC-BY 4.0
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    References listed on IDEAS

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    1. Janus, Katharina & Amelung, Volker Eric & Gaitanides, Michael & Schwartz, Friedrich Wilhelm, 2007. "German physicians "on strike"--Shedding light on the roots of physician dissatisfaction," Health Policy, Elsevier, vol. 82(3), pages 357-365, August.
    2. Lagarde, Mylène & Blaauw, Duane, 2017. "Physicians’ responses to financial and social incentives: A medically framed real effort experiment," Social Science & Medicine, Elsevier, vol. 179(C), pages 147-159.
    3. Milstein, Ricarda & Schreyoegg, Jonas, 2016. "Pay for performance in the inpatient sector: A review of 34 P4P programs in 14 OECD countries," Health Policy, Elsevier, vol. 120(10), pages 1125-1140.
    4. Timothy Besley & Maitreesh Ghatak, 2005. "Competition and Incentives with Motivated Agents," American Economic Review, American Economic Association, vol. 95(3), pages 616-636, June.
    5. Diwas S. Kc & Christian Terwiesch, 2009. "Impact of Workload on Service Time and Patient Safety: An Econometric Analysis of Hospital Operations," Management Science, INFORMS, vol. 55(9), pages 1486-1498, September.
    6. Wang, Jian & Iversen, Tor & Hennig-Schmidt, Heike & Godager, Geir, 2020. "Are patient-regarding preferences stable? Evidence from a laboratory experiment with physicians and medical students from different countries," European Economic Review, Elsevier, vol. 125(C).
    7. Deck, Cary & Jahedi, Salar, 2015. "The effect of cognitive load on economic decision making: A survey and new experiments," European Economic Review, Elsevier, vol. 78(C), pages 97-119.
    8. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
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    More about this item

    Keywords

    physician incentives; work motivation; time pressure; laboratory experiment;
    All these keywords.

    JEL classification:

    • C91 - Mathematical and Quantitative Methods - - Design of Experiments - - - Laboratory, Individual Behavior
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • M50 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Personnel Economics - - - General

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