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I soldi seguono un paziente sconosciuto
Author/s: Guido Citoni 
Year:  2003 Issue: Language: Italian 
Pages:  20 FullText PDF:  195 KB

This paper deals with a new method of paying doctors, based on «satisfaction» of patients. Among the methods currently used, no one, up to now, seems apt to give «voice» to the patient, being rather based on the idea of «exit» if not satisfied. This is because the methods based on capitation, salary, fees, budget, and so on can not take account of the success of the therapy; the payment, in fact, is either independent from limited cases of low quality visits (dealing with average quality) as in the case of capitation, salary and budget or could be too sensitive (fees) as the patient has the incentive to misreport the health gains, in order to be exempted from the payment of fees (this case applies when the patient has already decided to change the doctor) or, again, the patient can misreport the poor quality if he pays by fees but fears a negative reaction by his doctor and he still wants to be his client. Our thesis, shown by a simple model, is that we can devise a method that can induce a correct revelation of patient’s satisfaction. This could help in such cases when the dissatisfaction is «mild», and the patient do not want to use the option of «exit». The paper, moreover, tries to estimate the likely financial and distributional impact of our proposal for Italy.

Guido Citoni, in "ECONOMIA PUBBLICA " 3/2003, pp. , DOI:


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