Personal and professional motivation and the supply of health care

PhD: Personal and professional motivation and the supply of health care

The project included a comprehensive review of the theoretical and empirical literature with the objectives (i) to identify different existing models of intrinsic motivation and consider their relevance to the healthcare sector and (ii) to review empirical analysis of applications of this theory and again consider what lessons can be learned from this for the design of future analysis. Models of intrinsic motivation with testable hypotheses for application to the healthcare sector were developed. Opportunities to test these models were identified within the changing policy and contractual environment of the UK NHS.

Outcome and Translation

Financial incentives are extensively used within healthcare to improve the performance of organisations and individuals. The outcomes of this research provided evidence of whether such incentives have unintended effects on motivation and hence performance. For instance, an increase in the rate of performance target payments was found to effectively motivate Scottish GPs' healthcare supply, but it also 'crowded out' GPs' intrinsic motivation. Further, a change in the level of target thresholds motivated low-performing GPs significantly more than their high-performing counterparts.

PhD student: Yan Feng

Supervisors:Shelley Farrar and Ada Ma (HERU); Matt Sutton (University of Manchester)

Publications

Feng, Y. (2010) 'An economic analysis of intrinsic and extrinsic motivation in the supply of health care', PhD Thesis, University of Aberdeen.

Feng, Y., Farrar, S., Ma, A. and Sutton, M.A. (2011) 'The effect of an increase in the rate of payment on General Practitioners' intrinsic and extrinsic motivation', OHE Research Paper 11/05,Office of Health Economics.

Feng, Y., Ma, A., Farrar, S. and Sutton, M. (2012) 'The tougher the better: the effect of an increased performance threshold on the performance of general practitioners', OHE Research Paper 12/02, Office of Health Economics.

Feng, Y., Ma, A., Farrar, S. and Sutton, M. (2015) 'The tougher the better: an economic analysis of increased payment thresholds on the performance of general practices', Health Economics, 24(3), 353-371.

Presentations

Feng, Y. (2007) ‘Microeconometric analysis of health care datasets: an economic analysis of extrinsic and intrinsic motivation in the supply of health care. University of Aberdeen/Dundee.’ Scottish Institute for Research In Economics (SIRE) Health Economics PhD workshop, Arbroath, May 2007.

Feng, Y., Farrar, S., Sutton, M. and Ma, A. (2008) ‘The effect of a pay for performance system on GPs’ monetary and non-monetary motivations’, Joint Meeting of the UK HESG and the Nordic HESG, Aberdeen, August 2008.

Feng, Y. (2008)An economic analysis of extrinsic and intrinsic motivation in the supply of health care’, University of Aberdeen IAHS PhD Symposium, Aberdeen, December 2008.

Feng, Y., Farrar, S., Ma, A. (2012) ‘The supply of unpaid work’, UK HESG, Oxford, June 2012.