http://www.rwi-essen.de de-de RWI-Essen http://www.rwi-essen.de/media/images/rwi_logo.gif http://www.rwi-essen.de In recent years, several countries have introduced non-monetary performance incentives for health care providers to improve the quality of medical care. Evidence on the effect of non-monetary feedback incentives, predominantly in the form of public quality reporting, on the quality of medical care is, however, ambiguous. This is often because empirical research to date has not succeeded in distinguishing between the effects of monetary and non-monetary incentives, which are usually implemented simultaneously. We use a controlled laboratory experiment to isolate the impact of nonmonetary performance incentives: subjects take on the role of physicians and make treatment decisions for patients, receiving feedback on the quality of their treatment. The subjects’ decisions result in payments to real patients. By giving either private or public feedback we are able to disentangle the motivational eff ects of self-esteem and social reputation. Our results reveal that public feedback incentives have a significant and positive effect on the quality of care that is provided. Private feedback, on the other hand, has no impact on treatment quality. These results hold for medical students and for other students. http://www.rwi-essen.de/publikationen/ruhr-economic-papers/543/ RWI-Essen diskussionspapier-543 Fri, 10 May 2013 10:00:00 +0200 Recent reforms in health care have introduced a variety of pay-for-performance programs using financial incentives for physicians to improve the quality of care. Their effectiveness is, however, ambiguous as it is often difficult to disentangle the effect of financial incentives from the ones of various other simultaneous changes in the system. In this study we investigate the effects of introducing financial pay-for-performance incentives with the help of controlled laboratory experiments. In particular, we use fee-for-service and capitation as baseline payment schemes and test how additional pay-for-performance incentives affect the medical treatment of different patient types. Our results reveal that, on average, patients significantly benefit from introducing pay-forperformance, independently of whether it is combined with capitation or fee-for-service incentives. The magnitude of this effect is significantly infl uenced by the patient type, though. These results hold for medical and non-medical students. A cost-benefit analysis further demonstrates that, overall, the increase in patient benefits cannot overcompensate the additional costs associated with pay-for-performance. Moreover, our analysis of individual data reveals different types of responses to pay-for-performance incentives. We find some indication that pay-forperformance might crowd out the intrinsic motivation to care for patients. These insights help to understand the effects caused by introducing pay-for-performance schemes. http://www.rwi-essen.de/publikationen/ruhr-economic-papers/542/ RWI-Essen diskussionspapier-542 Wed, 8 May 2013 10:00:00 +0200 In recent health care reforms, several countries have replaced pure payment schemes for physicians (fee-for-service, capitation) by so-called mixed payment schemes. Until now it is still an unresolved issue whether patients are really better off after these reforms. In this study we compare the effects resulting from pure and mixed incentives for physicians under controlled laboratory conditions. Subjects in the role of physicians choose the quantity of medical services for different patient types. Real patients gain a monetary benefit from subjects’ decisions. Our results reveal that overprovision observed in fee-for-service schemes and underprovision observed in capitation schemes can, in fact, be reduced by mixed incentives. Interestingly, even the presentation of pure incentives as mixed incentives already significantly affects physicians’ behavior. Moreover, the mixed payment schemes generally provide a higher benefit-remuneration ratio than the respective pure payment schemes. Our findings provide some valuable insights for designing health care reforms. http://www.rwi-essen.de/publikationen/ruhr-economic-papers/541/ RWI-Essen diskussionspapier-541 Wed, 8 May 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen sonstigepublikation-144 Fri, 26 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen artikelref-371 Fri, 26 Apr 2013 10:00:00 +0200 The RWI/ISL Container Throughput Index has improved slightly from a revised 116.4 in February to 116.8 in March after seasonal adjustment. It still falls short of its January high, but this does not come as a surprise. The dip in Chinese container exports in February caused by... http://www.rwi-essen.de/presse/mitteilung/114/ RWI-Essen Wed, 24 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen artikelref-316 Wed, 24 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen artikelref-308 Tue, 23 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen artikelref-370 Tue, 23 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen artikelref-345 Tue, 23 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen elektronischepublikation-55 Mon, 22 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen artikelref-369 Sun, 21 Apr 2013 10:00:00 +0200 An upwards tendency re-emerged in the German economy in spring 2013. The situation in the financial markets has eased thanks to subsiding uncertainty regarding the future of the European Monetary Union. The headwind in the world economy has also tailed off somewhat. The institutes expect... http://www.rwi-essen.de/presse/mitteilung/113/ RWI-Essen Thu, 18 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen artikelref-344 Tue, 16 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen elektronischepublikation-54 Mon, 15 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen artikelref-367 Mon, 15 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen artikelref-368 Mon, 15 Apr 2013 10:00:00 +0200 Malaria kills about 1,500 children every day. Based on the Demographic and Health Surveys, we examine malaria treatment practices of various health care providers in sub-Saharan Africa, where more than 90 percent of the world’s deaths due to malaria occur. To assess the quality of each health care provider (including, among others, public health centers and traditional healers), we estimate the likelihood of providers to administer ineffective antimalarial drugs such as chloroquine in areas of known resistance, and to relieve children of malaria symptoms after having had fever within the last two weeks. Our results indicate that relative to self-medication, seeking treatment at most providers significantly increases the likelihood to take any antimalarial drug and decreases the likelihood to use chloroquine. Traditional healers do not exert any effect. http://www.rwi-essen.de/publikationen/ruhr-economic-papers/540/ RWI-Essen diskussionspapier-540 Fri, 12 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen artikelref-285 Mon, 8 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/ RWI-Essen diskussionspapier-539 Wed, 3 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/publikationen/rwi-konjunkturberichte/237/ RWI-Essen artikelsonst-237 Tue, 2 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/publikationen/rwi-konjunkturberichte/236/ RWI-Essen artikelsonst-236 Mon, 1 Apr 2013 10:00:00 +0200 http://www.rwi-essen.de/publikationen/rwi-konjunkturberichte/235/ RWI-Essen artikelsonst-235 Sat, 30 Mar 2013 10:00:00 +0100 The euro area is experiencing a severe and highly complex crisis. It comprises three problem areas, the difficulties of some highly indebted European sovereigns to ascertain funding at palatable cost, the disconcerting fragility of the European banking system and disappointing growth prospects in the euro area periphery. To make matters even worse, these problems have developed into a systemic crisis of the European Monetary Union (EMU), since observers have apparently developed fundamental doubts over its integrity. To overcome this systemic crisis, it would not be sufficient, if only the stronger euro area economies provided more solidarity, nor would it be sufficient, if only all of Europe adhered to ironclad budgetary discipline from now on. A European Redemption Pact could be a strong political commitment to the EMU and offer a bridge between the proponents of fiscal discipline and structural reform and those governments advocating for more support. This pact would entail two indispensable aspects, the codification of a credible and coherent reform path and a temporary and limited instrument for joint refinancing. http://www.rwi-essen.de/publikationen/ruhr-economic-papers/537/ RWI-Essen diskussionspapier-537 Tue, 26 Mar 2013 10:00:00 +0100 This study examines an increase in the early retirement age from 60 to 63 for the group of older unemployed men in Germany. As consequence of this policy reform, the time to retirement is increased from the perspective of recently unemployed individuals and therefore serves as a source of exogenous variation. We estimate continuous time hazard models for individuals at risk of leaving the state unemployment into employment or into early retirement due to exceptional rules. We find a positive impact of an increase in the early retirement age on the reemployment probability whereas the probability to retire early due to exceptional rules is not affected. http://www.rwi-essen.de/publikationen/ruhr-economic-papers/538/ RWI-Essen diskussionspapier-538 Tue, 26 Mar 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen artikelref-366 Fri, 22 Mar 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen artikelref-365 Fri, 22 Mar 2013 10:00:00 +0100 Widely considered as an important backbone of economies in developing countries, micro- and small enterprises face several constraints in doing business in Ghana. The creation of industrial zones (IZ) with improved access to infrastructure and secured land tenure is a potential remedy to promote local economic development. In this paper, we assess the effects of an intervention on business performance that establishes or upgrades IZs for micro- and small enterprises in Ghana based on firm-level data on 227 enterprises. Lacking reliable baseline data and an appropriate control group, we use retrospective questions to reconstruct the situation before the intervention. Furthermore, in order to account for general changes in the local economic environment, we examine regional agricultural market development over time. The results show that the establishment of IZs leads to the creation of new firms, but for existing firms that relocated to the IZs the effects on firm performance are negative. http://www.rwi-essen.de/publikationen/ruhr-economic-papers/536/ RWI-Essen diskussionspapier-536 Thu, 21 Mar 2013 10:00:00 +0100 RWI raised its economic growth forecast for Germany from 0.3% to 0.6% in 2013 compared with December 2012; growth of 2.1% is anticipated for 2014. This year the economy is expected to be driven mainly by domestic demand. In 2014 impulses from foreign trade are expected to... http://www.rwi-essen.de/presse/mitteilung/112/ RWI-Essen Wed, 20 Mar 2013 10:00:00 +0100 We estimate the effects on wage and employment growth rates of the introduction and subsequent increases of a substantial minimum wage in the main construction industry of Germany. Using a regional dataset constructed from individual employment histories, we exploit the spatial dimension and border discontinuities of the regional data to account for spillovers between districts and unobserved heterogeneity at the local level. The results indicate that the minimum wage increased the wage growth rate for East Germany but did not have a significant impact on the West German equivalent. The estimated eff ect on the employment growth rate reveals a contraction in the East of about 2.6 to 3.1 percentage points for a one-standard-deviation increase in the minimum-wage bite, amounting to roughly half of the overall decline in the growth rate, but no significant change is observed for the West. http://www.rwi-essen.de/publikationen/ruhr-economic-papers/535/ RWI-Essen diskussionspapier-535 Tue, 19 Mar 2013 10:00:00 +0100 In this paper, we study the long- and short-run relationship between regional public debt and economic performance for a sample of German federal states over the period of four decades (1970-2010). By choosing a sample of regional entities with comparable institutional settings, we complement the large literature on the debt-growth nexus based on heterogeneous cross-country samples. We estimate a dynamic error correction model that accounts for slope heterogeneity among cross-sections and the presence of unobserved common factors. While – in line with the Keynesian view – our findings hint at a non-linear inverted U-shape relationship between changes in the public debt intensity and economic growth in the short-run, we get strong statistical evidence for linear negative relationship between regional public depth and per capita GDP in the long-run. By means of a simple though experiment, we show that these negative long-run effects are not negligible for the size of interregional differences in per capita GDP levels and are in line with most international evidence on the detrimental growth effects of high public debt levels. Finally, these results also underline the need for effective fiscal rules at the federal state level in Germany. http://www.rwi-essen.de/publikationen/ruhr-economic-papers/534/ RWI-Essen diskussionspapier-534 Tue, 19 Mar 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen projektbericht-273 Mon, 18 Mar 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen artikelref-364 Mon, 11 Mar 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen artikelref-350 Mon, 11 Mar 2013 10:00:00 +0100 Der RWI-Konsumindikator ist im vierten Quartal 2012 von 54,8 auf 40,7 gesunken. Dies deutet auf eine schwächere Ausweitung der privaten Konsumausgaben im ersten Quartal 2013 hin, denn der Indikator weist erfahrungsgemäß einen Vorlauf von einem Quartal gegenüber der Vorquartalsrate des Privaten Konsums auf. Für das zweite Quartal 2013... http://www.rwi-essen.de/presse/mitteilung/109/ RWI-Essen Tue, 5 Mar 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen artikelref-318 Sat, 2 Mar 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen artikelref-330 Wed, 27 Feb 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen artikelref-363 Tue, 26 Feb 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen artikelref-362 Tue, 26 Feb 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen artikelref-342 Sat, 23 Feb 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen elektronischepublikation-53 Thu, 21 Feb 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen projektbericht-270 Wed, 20 Feb 2013 10:00:00 +0100 Second price allpay auctions (wars of attritions) have an evolutionarily stable equilibrium in pure strategies if valuations are private information. I show that for any level of uncertainty there exists a pure deviation strategy close to the equilibrium strategy such that for some valuations the equilibrium strategy has a selective disadvantage against the deviation if the population mainly plays the deviation strategy. There is no deviation strategy with this destabilizing property for all valuations if the distribution of valuations has a monotonic hazard rate. I argue that in the Bayesian game studied here, a mass deviation can be caused by the entry of a small group of agents. Numeric calculations indicate that the closer the deviation strategy to the equilibrium strategy, the less valuations are destabilizing. I show that the equilibrium strategy does not satisfy continuous stability. http://www.rwi-essen.de/publikationen/ruhr-economic-papers/533/ RWI-Essen diskussionspapier-533 Wed, 20 Feb 2013 10:00:00 +0100 http://www.rwi-essen.de/ RWI-Essen sonstigepublikation-142 Tue, 19 Feb 2013 10:00:00 +0100