The role of monetary and nonmonetary incentives on the choice of practice establishment: a stated preference study of young physicians in Germany.

Publisher: Blackwell Country of Publication: United States NLM ID: 0053006 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1475-6773 (Electronic) Linking ISSN: 00179124 NLM ISO Abbreviation: Health Serv Res Subsets: MEDLINE

Publication: Malden, MA : Blackwell
Original Publication: Chicago, Hospital Research and Educational Trust.

Choice Behavior* ; Motivation* ; Practice Management, Medical*; Physicians/*psychology; Adult ; Female ; Germany ; Humans ; Interviews as Topic ; Male ; Physicians/supply & distribution ; Surveys and Questionnaires

Introduction: The study aimed to quantify the preferences of young physicians for different attributes relevant to practice establishment in Germany.
Methods: Qualitative in-depth interviews of 22 physicians were conducted to identify relevant practice attributes. Based on this information, a questionnaire was developed containing a discrete choice experiment comprised of a "best-worst scaling" (BWS) task. It was mailed to a representative sample of 14,939 young physicians who were close to making a decision regarding practice establishment. Regression analysis was used to estimate utility weights quantifying physicians' preferences for practice attributes.
Results: Qualitative interviews identified six attributes: "professional cooperation,""income,""career opportunities of the partner,""availability of child care,""leisure activities," and "on-call duties." For the BWS task, 5,026 returned questionnaires were analyzed. Results indicated that a change in income led to the largest utility change compared with changes in other attributes. Additional net income to compensate the disutility of a rural practice as compared with an urban practice was 9,044euro/months (U.S.$ 11,938). Yet, nonmonetary attributes such as on-site availability of childcare and fewer on-call duties would decrease the additional income required to compensate the disutility of a rural practice.
Discussion: The results offer quantifiable information about young physicians' preferences in establishing a practice. It can assist health policy makers in developing tailored incentive-based interventions addressing urban-rural inequalities in physician coverage.

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Date Created: 20090929 Date Completed: 20100616 Latest Revision: 20211020

20221213

PMC2813445

10.1111/j.1475-6773.2009.01045.x

19780851