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- W2019420180 abstract "Previous attempts to model some aspects of physician behaviour include those of Evans, Sloan and Feldman and Wolfson. It is suggested that the introduction of knowledge as a distinct element in a microeconomic model of physician behaviour is preferable to the inclusion of a variable called ‘discretionary influence’ or ‘quality of care’ in the physician's utility function. This is because the properties of functions containing either of these variables appear to be indeterminate. By comparison the properties of the knowledge constraints can be specified with some confidence. The factors affecting a physician's demand for treatment on behalf of patients are identified as (1) the physician's objective function, (2) his knowledge and (3) the availability of medical resources. Furthermore, the knowledge element can be sub-divided into two parts: the set of prior probabilities and the set of likelihood functions. The former may be identified with the physician's local knowledge, whereas the latter may be associated with the physician's medical training. A significant fraction of the growing demand for hospital care has been attributed to changes in medical technology. During the late fifties and afterwards ‘more cases became treatable’ and physicians, it is argued, cannot resist the ‘technological imperative’. The paper shows that the model may be used to generate testable hypothesis regarding the adoption by physicians of both process and product innovations. The discussion of the physician's medical knowledge is fundamental to the inducement mechanism. The policy instruments available to achieve an optimal diffusion of innovations are reviewed. Des efforts en vue de modéliser certains aspects du comportement des médecins ont été entrepris par Evans, Sloan et Feldman et Wolfson. Nous suggérons ici que l'introduction de la connaissance en tant qu'élément distinct dans un modèle microéconomique du comportement médical est préférable à l'inclusion de variables telles que l'influence discrétionnaire' des soins' dans la fonction d'utilité du médecin. Il en va ainsi parce que les propriétés des fonctions contenant l'une ou l'autre de ces variables se révèlent indéterminées. Inversément, les propriétés des contraintes sur la connaissance peuvent être spécifiées avec une certaine confiance. Les facteurs qui affectent la demande des traitements par un médecin pour son patient sont (1) la fonction objective du médecin, (2) son degré de connaissance et (3) la disponibilité de ressources médicales. En outre, l'élément ‘connaissances’ peut être subidivisé en deux composantes: l'ensemble des probabilités a priori et celui des fonctions de vraisemblance. Le permier est associé aux connaissances particulières du médecin tandis que le second correspond à sa formation médicale. Une part importante de la demande croissante pour les soins hospitaliers a été attribuée aux changements dans la méthodologie médicale. Depuis les années 50, de plus en plus de cas peuvent être traités et les médecins ne peuvent résister aux impératifs technologiques. Dans ce papier, il est montré que le modèle proposé peut générer des hypothèses testables quant à l'adoption par le médecin des innovations en termes de processus ou de produits. En outre, nous passons en revue les instruments disponibles pour obtenir une diffusion optimale des innovations." @default.
- W2019420180 created "2016-06-24" @default.
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- W2019420180 date "1985-01-01" @default.
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- W2019420180 title "Physicians and medical innovation" @default.
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- W2019420180 doi "https://doi.org/10.1016/0277-9536(85)90179-0" @default.
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