Melbourne Institute of Applied Economic and Social Research - Research Publications

Permanent URI for this collection

http://hdl.handle.net/11343/414

Search Results

Now showing 1 - 10 of 12

Loss aversion, reference dependence and diminishing sensitivity in choice experiments

Scott, A ; Witt, J (Elsevier, 2020-12-01)

This paper tests for the existence of loss aversion, reference dependence and diminishing sensitivity in a discrete choice experiment (DCE). A status quo alternative is introduced in a DCE of nurses' job choices and modeled as an individual-specific third alternative representing the respondent's current job. This provides a feasible method for including a status quo, which changes the reference point for each respondent. The increased salience of the status quo changes the size of any losses or gains when comparing Job A or Job B with their current situation, and since losses are valued more than gains, affects the marginal utility of each attribute. Models that differentially incorporate loss aversion, reference dependence and changes in sensitivity yield varying estimates of marginal rates of substitution, suggesting that consideration of these effects is important, particularly when policy implications are sought.
The impact of price transparency on consumers and providers: A scoping review

Zhang, A ; Prang, K-H ; Devlin, N ; Scott, A ; Kelaher, M (Elsevier, 2020-08-01)

Escalating levels of healthcare spending and price variation in the healthcare market have driven government and insurer interest in price transparency tools that are intended to help consumers shop for services and reduce overall healthcare spending. However, it is unclear whether the objectives of price transparency are being achieved. We conducted a scoping review to synthesize the impact of price transparency on consumer, provider, and purchaser behaviours and outcomes. Price transparency tools had weak impact overall on consumers due to low uptake, and mixed effects on providers. Price-aware patients chose less costly services that led to out-of-pocket cost savings and savings for health insurers; however, these savings did not translate into reductions in aggregate healthcare spending. Disclosure of list prices had no effect, however disclosure of negotiated prices prompted supply-side competition which led to decreases in prices for shoppable services.
Does digital health technology improve physicians' job satisfaction and work-life balance? A cross-sectional national survey and regression analysis using an instrumental variable

Zaresani, A ; Scott, A (BMJ Journals, 2020-01-01)

Objectives To examine the association between physicians’ use of digital health technology and their job satisfaction and work–life balance. Design A cross-sectional nationally representative survey of physicians and probit regression models were used to examine the association between using digital health technology and the probability of reporting high job satisfaction and a good work–life balance. Models included a rich set of covariates, including physicians’ personality traits, and instrumental variable analysis was used to control for bias from unobservable confounders and reverse causality. Setting Clinical practice settings in Australia, including physicians working in primary care, hospitals, outpatient settings, and physicians working in the public and private sectors. Participants Respondents to wave 11 (2018–2019) of the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey of doctors. The analysis sample included a broadly nationally representative sample of 7043 physicians, including general practitioners, specialists and physicians in training. Primary and secondary outcome measures The proportion of respondents who used any digital health technology; proportion answered ‘moderately satisfied’ or ‘very satisfied’ to the statement on job satisfaction: ‘Taking everything into account, how do you feel about your work’; proportion agreeing or strongly agreeing to the statement on work–life balance: ‘The balance between my personal and professional commitments is about right.’ Results Physicians with positive beliefs about the effectiveness of using digital health technology were 3.8 percentage points (95% CI 2.7 to 5.0) more likely to use digital health technology compared with those who did not. Physicians with colleagues who already used digital health technology were also 4.1 percentage points (95% CI 2.6 to 5.6) more likely to use digital health technology. The availability of IT support and lack of privacy concerns increased the probability of using digital health technology by 1.6 percentage points (95% CI 1.0 to 2.3) and 0.5 percentage points (95% CI 0.1 to 1.0). Physicians who used digital health technology were 14.2 percentage points (95% CI −1.3 to 29.7) and 20.3 percentage points (95% CI 2.4 to 38.1) more likely to report respectively higher job satisfaction and good work–life balance, compared with the physicians who did not use it. Conclusions Findings suggested digital health technology served more as a work resource than work demand for physicians who used it.
The impact of COVID-19 on GPs and non-GP specialists in private practice

Scott, A (Melbourne Institute of Applied Economic and Social Research, 2020)

The healthcare system in Australia has not been overwhelmed by the COVID-19 pandemic as initially expected. Nevertheless, there have been significant changes in the use of healthcare from the suspension of non-urgent elective surgery, social distancing restrictions that have discouraged people from leaving home, public fear of contracting or spreading the virus in health facilities, and increased household financial pressure that reduces the affordability of out-ofpocket payments. The aim of this report is to examine the impact of the COVID-19 pandemic on General Practitioners (GPs) and non-GP specialists working in private practice. It examines the short-term effects on doctors’ working patterns and mental health, how doctors have responded and how they have been supported during the pandemic. New evidence is presented from the Medicine in Australia: Balancing Employment and Life (MABEL) COVID-19 Short Online Survey (SOS) – MABEL COVID-19 SOS – which was completed by a representative sample of 2,235 GPs and non-GP specialists between 14 and 24 May 2020, with comparison to the MABEL Wave 11 survey conducted in 2018-19.
Nursing Home Competition, Prices and Quality: A Review and Some Lessons for Australia

Yang, O ; Yong, J ; Scott, A (Melbourne Institute of Applied Economic and Social Research, 2020-06-01)

In recent years, with the aim of containing cost pressure and improving efficiency, many countries have begun to introduce market mechanisms into the aged care sector. Under the right conditions, competition can spur providers to compete by cutting costs, offering better prices and higher quality of services. However, in aged care, market failures can be severe. Information about prices and quality may not be readily available and search costs can be high. This study undertakes a scoping review of the literature on competition in the nursing home sector, with an emphasis on research examining how competition affects prices and quality of care. Online databases were used to identify studies in English language published between 1988–2020. A total of 44 publications covering nine countries are included in this review. On the relationship between competition and quality, the literature offers conflicting evidence. Some studies find greater competition leading to higher quality, while others find the opposite effect. Institutional features such as the presence of binding supply restrictions on nursing homes and public release of information on quality appear to be important considerations. On the price effect of competition, most studies find that greater competition tends to result in lower prices, although the effect is small. The literature offers several lessons for Australia, including whether increasing subsidies can result in higher quality and the role of public reporting of quality ratings in fostering competition.
Private or Public? The declining growth in the use of private healthcare in Australia

Bai, T ; Mendez, S ; Scott, A ; Yong, J (Melbourne Institute of Applied Economic and Social Research, 2020-10-01)

The past five years has seen a steady decline in private health insurance (PHI) membership in Australia. With rising premium prices and out-of-pocket costs, private healthcare has become increasingly unaffordable in an era of low wage growth. Given the private health sector relies heavily on PHI funding, this Research Insight explores how the decline in private health membership has affected the private hospital sector in Australia.
Who is avoiding necessary health care during the COVID-19 pandemic?

Zhang, Y ; Liu, J ; Scott, A (Melbourne Institute of Applied Economic and Social Research, 2020-06-01)

Australians experiencing high levels of financial stress and mental distress are not seeking needed health care. This study looks into what policies could help encourage greater use of necessary health care to improve wellbeing and avoid more expensive care later on.
Using health care during the pandemic: should I stay or should I go?

Zhang, Y ; Liu, J ; Scott, A (Melbourne Institute of Applied Economic and Social Research, 2020-09-01)

The COVID-19 pandemic has caused significant financial and mental distress for many Australians, which according to results from Taking the Pulse of the Nation in early June, has caused some to avoid visiting a health care professional when needed. As the pandemic continues, are people still delaying seeing a doctor or has their been a resurgence in visits after people delayed their care earlier in the year? In this Research Insight, Professor Yuting Zhang, Dr. Judith Liu, and Professor Anthony Scott examine Australians' use of health care and telehealth, focusing on what changes have occured since early June. To understand how COVID-19 has impacted decision-making around seeing a health care professional, data from Taking the Pulse of the Nation have been used to see who has avoided seeing a doctor, who has sought health care, and who has used telehealth.
Who is ditching private health insurance during the pandemic?

Zhang, Y ; Liu, J ; Scott, A (Melbourne Institute of Applied Economic and Social Research, 2020-11-01)

Following the recent increase in private health insurance (PHI) premiums in October, as well as people's growing financial and mental stresses due to the COVID-19 pandemic, many Australians may be wondering whether they should drop or downgrade their PHI. In this Research Insight, authors Professor Yuting Zhang, Dr Judith Liu, and Professor Anthony Scott examine how Australians have changed their PHI memberships during the pandemic. Using data from the Melbourne Institute's Taking the Pulse of the Nation survey, they look specifically at who has dropped, downgraded or upgraded their PHI since March 2020.
Preferences of physicians for public and private sector work

Scott, A ; Holte, JH ; Witt, J (BioMed Central, 2020-08-10)

Background The public-private mix of healthcare remains controversial. This paper examines physicians’ preferences for public sector work in the context of dual practice, whilst accounting for other differences in the characteristics of jobs. Methods A discrete choice experiment is conducted with data from 3422 non-GP specialists from the Medicine in Australia: Balancing Employment and Life (MABEL) panel survey of physicians. Results Physicians prefer to work in the public sector, though the value of working in the public sector is very small at 0.14% of their annual earnings to work an additional hour per week. These preferences are heterogeneous. Contrary to other studies that show risk averse individuals prefer public sector work, for physicians, we find that those averse to taking career or clinical risks prefer to work in the private sector. Those with relatively low earnings prefer public sector work and those with high earnings prefer private sector work, though these effects are small. Conclusions Other job characteristics are more important than the sector of work, suggesting that these should be the focus of policy to influence specialist’s allocation of time between sectors.