The impact of financial incentives on physician empathy: A study from the perspective of patients with private and statutory health insurance

PATIENT EDUCATION AND COUNSELING

卷:84

Article

Neumann, Melanie^1,2,3,4  Bensing, Jozien^5,6  Wirtz, Markus⁷  Wuebker, Ansgar⁸  Scheffer, Christian^4,9  Tauschel, Diethard⁹  Edelhaeuser, Friedrich⁹  Ernstmann, Nicole^2,3  Pfaff, Holger^2,3 

[1] Private Univ Witten Herdecke, Integrated Curriculum Anthroposoph Med ICURAM, Gerhard Kienle Inst Med Theory Integrat & Anthrop, Fac Hlth,Med Dept,Gerhard Kienle Chair Med Theory, D-58448 Witten, Germany

[2] Univ Cologne, Dept Human Sci, Inst Med Sociol Hlth Serv Res & Rehabil Sci, D-5000 Cologne 41, Germany

[3] Univ Cologne, Dept Med, D-5000 Cologne 41, Germany

[4] Private Univ Witten Herdecke, Fac Hlth, Interdisciplinary Ctr Hlth Serv Res, D-58448 Witten, Germany

[5] Netherlands Inst Hlth Serv Res, NIVEL, Utrecht, Netherlands

[6] Univ Utrecht, Dept Hlth Psychol, Utrecht, Netherlands

[7] Univ Educ Freiburg, Inst Psychol, Freiburg, Germany

[8] Private Univ Witten Herdecke, Dept Inst Econ & Hlth Syst Management, D-58448 Witten, Germany

[9] Private Univ Witten Herdecke, Dept Med, CEWIM, D-58448 Witten, Germany

关键词: Physician empathy;    Financial incentive;    Private health insurance;    Statutory health insurance;    Fee-for-service;    Capitation;   

DOI  :  10.1016/j.pec.2010.07.012

来源: Elsevier

【 摘 要 】

Objective: We hypothesized that patients' ratings of physician empathy (PE) would be higher among those with private health insurance (PHI, referring to financial incentive) than among patients with statutory health insurance (SHI). Methods: A postal survey was administered to 710 cancer patients. PE was assessed using the Consultation-and-Relational-Empathy measure. T-tests were conducted to analyse whether PHI and SHI-patients differ in their ratings of PE and variables relating to contact time with the physician. Structural-equation-modelling (SEM) verified mediating effects. Results: PHI-patients rated physician empathy higher. SEM revealed that PHI-status has a strong significant effect on frequency of talking with the physician, which has a strong significant effect (1) on PE and (2) has a moderate effect on patients' perception of medical staff stress, thereby also affecting patients' ratings of PE. Conclusions: Our findings suggest that PHI-status is one necessary precondition for physicians spending more time with the patient. Spending more time with the PHI-patient has two major effects: it results in a more positive perception of PE and positively impacts PHI-patients' perception of medical staff stress, which in turn, again influences PE. Practical implications: Health policy should discuss these findings in terms of equality in receiving high-quality care. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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