Personal Incentives Research Articles

Patients’ attitudes towards and experiences of generic drug substitution in Norway

The aim of the study was to assess patients' attitudes towards and experiences of generic substitution 3 years after generic substitution of prescription medicines was permitted in Norway. Prescriptions from 2,128 consecutive patients in a Norwegian pharmacy were retrospectively reviewed to identify all patients (n=274) receiving eight or more different prescription drugs on the fifth level in the Anatomical Therapeutic Chemical (ATC) classification system during the last 6 months. An age-adjusted control group (n=269) of patients receiving three to seven different prescription drugs was randomly selected. Of the 543 patients, 386 were eligible for inclusion. Both groups received a mailed questionnaire addressing their experiences with and attitudes towards generic substitution. The overall response rate was 73% (281/386) and the average age of the respondents was 66 years old. The study found that patients who reported to have received information from their physician or the pharmacy about generic substitution were more likely to have switched (P<0.001). About half (138/281) of the patients had experienced a generic switch, and a higher proportion of the polypharmacy patients had their medication substituted compared to the control patients (P<0.001). Altogether 50 (36%) of the patients who had experienced a switch, reported one or more negative experiences connected to the substitution, and 29 of these (21%) reported an overall negative experience after the change. The experiences of the patients were not related to age, gender, or number of medications or information about generics from either the pharmacy or the physician. About 41% of the patients would not switch if they had no personal economic incentives. About 1/3 of the patients who had their medication substituted reported negative experiences. Generic drug substitution for a number of patients is not considered an equal alternative to branded drugs, and these patients may need additional information and support. The lack of correlation between patient experiences and age, gender, and medical regimen complexity is interesting and should be investigated further.

Incentives to Exercise

Can incentives be effective when trying to encourage the development of good habits? We investigate the effect of paying people a non-trivial amount of money to attend an exercise facility over a period of time. We find that doing so leads to an attendance level that is twice as high as the level when people have not been paid, even well after the end of the intervention. This result is driven primarily by the impact on non-users (people who did not previously attend the gym), as regular users are essentially unaffected. We observe no difference across gender. Even though personal incentives to exercise are already in place, it appears that the financial incentive serves as a catalyst to get some people past the threshold of actually getting started with an exercise regimen. We argue that there is scope for financial intervention in habit formation, particularly in the area of health.

More Isn’t Always Better: Cost-Effectiveness Analysis and the Case for Using a Split-Night Protocol

Free AccessMore Isn’t Always Better: Cost-Effectiveness Analysis and the Case for Using a Split-Night Protocol Vishesh K. Kapur, M.D., M.P.H., Sean D. Sullivan, Ph.D. Vishesh K. Kapur, M.D., M.P.H. Department of Medicine Search for more papers by this author , Sean D. Sullivan, Ph.D. Departments of Pharmacy and Health Services, University of Washington, Seattle, WA Search for more papers by this author Published Online:April 15, 2006https://doi.org/10.5664/jcsm.26509Cited by:8SectionsPDF ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations About Previous article Next article FiguresReferencesRelatedDetailsCited by Textile triboelectric nanogenerators for self-powered biomonitoringLama J, Yau A, Chen G, Sivakumar A, Zhao X and Chen J Journal of Materials Chemistry A, 10.1039/D1TA02518J, Atwood C and Strollo P Positive Airway Pressure in the Treatment of Sleep Apnea–Hypopnea Sleep Disorders Medicine, 10.1007/978-1-4939-6578-6_34, (619-645), . Buchanan P and Grunstein R Positive-pressure treatment of obstructive sleep apnea syndrome Sleep Disorders, 10.1016/B978-0-444-52006-7.00028-9, (421-439), . Buchanan P and Grunstein R Positive Airway Pressure Treatment for Obstructive Sleep Apnea–Hypopnea Syndrome Principles and Practice of Sleep Medicine, 10.1016/B978-1-4160-6645-3.00107-9, (1233-1249), . Sanders M, Strollo P, Atwood C, Stiller R and O’Donnell C Presión respiratoria positiva en el tratamiento de la apnea-hipopnea del sueño* Medicina de los Trastornos del Sueño, 10.1016/B978-84-8086-733-7.00025-5, (340-360), . Clinical assessment of the obstructive sleep apnoea/hypopnoea syndromeRiha R Therapeutic Advances in Respiratory Disease, 10.1177/1753465810365080, Vol. 4, No. 2, (83-91), Online publication date: 1-Apr-2010. The obstructive sleep apnoea/hypopnoea syndrome – An overviewPataka A and Riha R Respiratory Medicine CME, 10.1016/j.rmedc.2009.03.001, Vol. 2, No. 3, (111-117), . Sanders M, Strollo P, Atwood C, Stiller R and O'Donnell C Positive Airway Pressure in the Treatment of Sleep Apnea-Hypopnea Sleep Disorders Medicine, 10.1016/B978-0-7506-7584-0.00025-2, (340-360), . Volume 02 • Issue 02 • April 15, 2006ISSN (print): 1550-9389ISSN (online): 1550-9397Frequency: Monthly Metrics History Published onlineApril 15, 2006 Information© 2006 American Academy of Sleep MedicinePDF download

Personal and Group Incentives to Invest in Prosocial Behavior: A Study in the Bolivian Amazon

Ethnographic evidence, empirical research, and results of experimental studies suggest that people across cultures invest in prosocial behavior, but little research addresses the relative importance of personal versus group incentives to invest in prosocial behavior. We estimate the relative weight of personal and group incentives for households to invest in prosocial behavior using two waves of panel data (2001 and 2002) from ca. 350 Tsimane' Amerindians, a foraging-farming society in the Bolivian Amazon. We found that some personal incentives bore a significant association with household decisions to display prosocial behavior. Consistent with previous research, we found that investments in prosocial behavior first rise and then decline with age, and that cash income bore a positive association with investments in prosocial behavior. We found no evidence that group incentives were associated with personal investments in prosocial behavior once we controlled for fixed attributes of villages, but those fi...

A ‘Race to the Bottom’ in the EU?

The objective of this article is to analyse the incentives of Member States as well as of companies in order to establish whether or not the EU can expect to experience a situation in which there is competition for company incorporations. In the European literature on competition between company law regimes, it has been argued that if conditions for competition were established in the EU then there would not be competition to the same extent as in the USA, primarily because the European Member States lack a financial incentive to compete. However, the financial incentive can not stand alone, and the full range of the Member States' incentives is therefore examined in the context of interest group theory. Whether or not a company will forum shop for the most favourable company law depends on whether the decision-makers of the company have a personal incentive to do so. It is examined who the decision-makers are in different situations and it is concluded that regardless of who may be considered to be the actual decision-maker, it is likely that both the promoters of companies and companies themselves will have a number of incentives, varying in kind and intensity, to forum shop.

Sex Differences in Correlations between Personal Incentives and Self-Motivation, and Occurrence of Perceived Positive Changes in Feeling States after Exercise

Personal incentives for exercising of weight management and appearance improvement were significantly correlated with percentage of positive exercise-induced feeling changes in women (n=23) and men (n=20) initiating 12-wk. exercise programs. No significant differences were found by sex. Self-motivation was also significantly related to occurrence of positive feeling changes for men.

How to Integrate Disability Benefits into an Individual Account System: The Chilean Model

Chile offers an innovative approach to disability insurance within a multi-pillar social security system. The individual's retirement savings account is used as part of his disability insurance, but if he becomes disabled the account is topped up enough to finance a defined benefit annuity that pays 70% of the reference wage. This is accomplished primarily through the private insurance market, but with government providing regulations and back-up guarantees. The private pension funds and insurance companies that participate in the assessment process have a pecuniary interest in keeping costs low, unlike most public systems that are run by agencies without a personal incentive to contain costs. The individual accounts, used for old age retirement savings, help to finance the disability and survivors' insurance as a joint product. This further keeps costs down and makes the system less sensitive to demographic shocks than a public pay-as-you-go system would be. However, pre-funding a defined benefit makes system costs much more sensitive to interest rate shifts. The defined benefit reduces risk to the worker but non-differentiated pricing creates cross-subsidies and, in a competitive market, incentives for creaming. Some of the cost reductions to the private insurance may imply a larger future public obligation, due to the minimum pension guarantee. This study examines the potential successes and pitfalls of this mixed public-private funded system of disability insurance and evaluates whether it provides a useful model for the US and other countries.

Sustainable entrepreneurship: regional innovation cultures in the ecological food sector

How do regional innovation cultures in the eco-food sector develop? And how can they be supported and empowered within a national strategy for sustainable agriculture? Based on three case studies, this paper explores key characteristics and dynamics of ongoing regional innovation cultures within the ecological food sector in Norway. The common denominator of each case is a strong community of innovative practitioners that shape their activities around intentional interaction, dialogue and inquiry with a long term commitment. They sustain and develop common tasks by uniting individual commitment to shared questions. Thereby, the intensity and ecology of the shared questions build the carrying capacity and structure of the innovation culture. Each case is unique by being rooted in personal incentives and shared ownership to tasks. Structurally their uniqueness demonstrates three modes of activity and roots of identity, related to the three concepts of institutional entrepreneurship, market entrepreneurship and cultural entrepreneurship. Four implications are finally drawn for regional innovation strategies within the eco-food sector: (1) build strategies on the activity of pioneering local/regional cultures of practice; (2) analyse their entrepreneurial uniqueness and social ecology; (3) facilitate a broader entwining of institutional, market and cultural entrepreneurship; and (4) develop competency and cultures of inquiry linked to entwined entrepreneurship. A corresponding research strategy should acknowledge, build on and strengthen the culture of inquiry embedded in the regional communities of practice.

Difference in the motivation between participants and non-participants in a social movement

This paper aims to reconsider the manner in which individuals who determine a collective goal are classified as participants and non-participants from the perspective of meaning construction. The resource mobilization theory and theories on the cultural conditions of the host society have focused on the methods of mobilization. In this paper, I used the interview survey method to examine both the participants and non-participants who support the collective goal. The empirical case study is a movement network supporting the rights of the Ainu and other indigenous populations. This network comprises a large number of non-Ainu people.First, some of the non-participants stated that if they continued to maintain their social positions, they would not be permitted to participate in the movement. In other words, the non-participants referred to the need to change the course of their lives if they participated in this movement.Second, the contents of the participants' meaning construction also revealed their mental conflict with regard to their participation as non-Ainu people. However, they attempted to overcome this dilemma through their double motives. Participants stated that their motivation to participate in the movement results from a combination of a resonance for a collective goal as well as a personal incentive to learn about the Ainu culture.Third, this study has shown that previous leaders of this movement have maintained the importance of considering their social stance. These leaders proposed the notion of self-denial (Jiko-Hitei). In contrast, this idea is presently considered as an ineffective tool for mobilization. However, this situation does not imply that the notion of self-denial has been discarded. The rationale behind this norm is currently construed in a different manner.

Successful knowledge management requires a knowledge culture: a case study

Culture is widely acknowledged to be a critical success factor in knowledge management (KM). This paper presents the case of KM implementation at MKS, an IT consulting firm based in India. Although the KM initiative at MKS had many of the hallmarks associated with successful KM projects, the initiative failed to get off the ground due to the absence of a ‘knowledge culture’ within the organisation. Subsequent interviews with MKS staff uncovered a range of cultural themes that appeared to impede the institutionalisation of KM at MKS. These cultural themes included:internal competitiveness among MKS staff resulting in ‘knowledge hoarding’,a lack of personal reward and incentive to engage in knowledge sharing,concerns over job security and the ‘devaluation’ of employees,stigma associated with the reliance on someone else's ideas,preference for a face-to-face mode of knowledge sharing over a tool-supported approach anddoubts over the quality of knowledge shared by more junior staff.

Monitoring and Cost-Effectiveness in Development Management

I would like to argue that the tasks undertaken by the large multilateral and bilateral donor agencies require a particularly high analytic standard, but several incentives that influence development practice—political incentives for donor and recipient governments, organizational incentives for development agencies, and personal incentives for managers—have led to positive bias and analytic compromise. The central challenge in the management of development assistance is to maintain this kind of consciousness—this analytic perspective—among the corps of professional staff. Some might like to think that development can be achieved by getting governments to liberalize markets or by getting local participation in project management, and these may well be important tactics. Intuition suggests and experience teaches, however, that there can be no formula for successful development. Each investment presents a unique design and management challenge. There are two problems in maintaining the will and the capacity toaddress this challenge: an incentive problem and one we can call intellectual or cognitive. The key to solving both problems, or so I will argue, is strong evaluation.

Personal incentives for participation in summer children's camps: Investigating their relationships with satisfaction and loyalty

The objective of this study was to investigate consumer behaviour issues in a summer children's camp setting. Specifically, the study aimed to: (a) identify the personal incentives that drive children to participate in summer camps, (b) test gender and age differences in children's personal incentives, and (c) investigate which of the incentives are the most important ones in predicting children's satisfaction, loyalty, and word-of-mouth communications. The sample of the study consisted of 453 (N = 453) children, who participated in a camp located at the mainland of north Greece. The results indicated that: (a) six personal incentive dimensions revealed from a factor analysis of the personal incentive scale, named: Camp Experience, Socialization I (making new friends), Socialization II (meeting old friends), Independence, Activities Participation, and Parents' Decision, (b) Socialization I and Camp Experience were the two highest scored dimensions, (c) girls were more driven by Socialization II (meeting old friends) related incentives than boys, who scored higher on the Activities' Participation dimension, (d) older and more experienced campers expected more independence and social interaction than younger campers, who expected to participate in a variety of sport and cultural activities, and (e) the Camp Experience dimension was the most powerful and consistent predictor of satisfaction, loyalty and word-of-mouth communications. The managerial implications of these results are discussed.

Homeownership as a Constraint on Asset Allocation

Personal preferences and financial incentives make desirable for most families. Once a home is purchased they find it impractical (costly) to frequently change their ownership of residential real estate. Thus, by deciding how much home to buy, a family constrains their ability to adjust their asset allocation between residential real estate and other assets. To analyze the impact of this constraint on consumption, welfare, and post-retirement wealth, we first investigate a representative individual's optimal asset allocation decisions when they are subject to a homeownership Next, we perform a thought experiment where we assume the existence of a market where a homeowner can sell, without cost, a fractional interest in their home. Now the housing choice decision does not constrain the individual's asset allocations. By comparing these two cases, we estimate the differences in post-retirement wealth and the welfare gains potentially realizable if asset allocations were not subject to a constraint. For realistic parameter values, we find that a representative homeowner would require between a 2 and 25 percent increase in total net worth to achieve the same level of utility as would be achievable if the choice of a home could be separated from the asset allocation decision.

Cultures of Illegality in the National Hockey League

When people commit illegal acts, are they influenced by the wider culture of illegality around them, or do personal incentives matter most? If someone experiences a more pronounced culture of illegality, whether he increases his illegality depends greatly on his historical involvement with illegality and how his wealth also changes. The National Hockey League provides a useful setting for empirical analysis of these issues. Using a constructed panel data set, which tracks player behavior on a game‐by‐game basis over the course of a season, we examine how various aspects of the wider culture of illegality affect individual illegality. We also take advantage of what amounts to a natural experiment in exogenous cultural change, by examining the behavior of players traded during the season under analysis. The empirical results are consistent with the economic model of crime, but cultural factors generally appear less influential and robust than individual‐level incentives.

Cultures of Illegality in the National Hockey League

1. IntroductionThe economic model of crime demonstrates how an individual might decide to engage in illegal activity. It demonstrates that such activity may be motivated by incentives associated with a person's human capital skills, the availability of legitimate activity, preferences for risk, the potential sanction, and the probability of detection. But individualized as it may be, illegal activity still takes place in a social context. Fundamentally, a person who commits a crime has violated laws or other institutions formed by the larger social group. By the same token, society's collective experiences, fears, expectations, and reactions in relation to crime may well influence the individual decision to commit crime. Given crime's social content, can we disentangle the influence of social environment, or culture, from the individual factors that determine crime?1 This article addresses this question.In the economic model of crime, hypothetical agents consider the various benefits and costs of legal and illegal activity and then decide how much time to devote to either activity. A more criminalized culture of illegality might enhance the potential benefit of crime through tacit or overt encouragement of crime and might reduce the potential cost of crime by relieving some of the stigma (social cost) associated with it.2 If individuals experience a more pronounced culture of illegality, they might engage in more illegal activity on that basis; in principle, if we could remove them from that culture, they would less likely engage in illegal activity. But many factors complicate this possibility.Over time and over space, societal crime rates appear to vary in the opposite direction as overall wealth, whether measured in terms of legal wage opportunities or income level.3 Therefore, any hypothetical change in a person's culture of illegality would almost certainly imply a change in his wealth or his opportunity to engage in legal time allocation. Furthermore, an individual who experiences a cultural change carries along a set of personal characteristics (e.g., tastes for illegality or for risk) that likely do not vary across cultures. Testing empirically for the influence of culture on individual-level crime thus requires a sample of individuals who engage in both legal and illegal activity, data on their personal incentives to engage in legal and illegal behavior (including their wealth), data on their cultures of illegality, and some exogenous cultural change that affects some subset of them. The data used in this study, relating to players in the National Hockey League (NHL), possess each of these features.As illustrated by Allen (2002), the NHL provides a useful setting for analyzing the economic model of crime, especially when one follows the legal and illegal behavior of a sample of players over a period of time, in a panel setting. Like citizens in society, hockey players react to a number of factors interpretable as benefits or costs associated with committing illegal activity (on-ice rules violations, which result in penalties). For example, a player's own history of involvement in illegality, such as measured by his career penalty minutes, likely indicates the manner by which he generally achieves success in the sport, while deficiencies in his current team at penalty killing (defending against goals while shorthanded) likely act as costs and, hence, as deterrents.Because hockey players have team-based objectives, their behavior may be influenced by the values and expectations of a larger social group (the team, the league, fans) with respect to physically aggressive play. In ice hockey, the culture of illegality may even have a situational character: In a given game, the degree to which one player's illegality is accepted may emanate in part from the level of illegality or violence demonstrated by the opposing team in that game. Also, because some players get traded from one team to another during the course of a season, we can observe economic agents who experience exogenous change in the culture of illegality around them. …

Agency problems and debt financing: leadership structure effects

In previous research, Friend and Hasbrouck theorized that managerial insiders (officers and directors) have a personal incentive to cause the firm to use less than the optimal amount of debt in its capital structure. They suggested this occurs because officers and directors have a large proportion of their personal wealth invested in the firm in the form of common stock holdings and firm‐specific human capital. This makes managerial insiders reluctant to use the optimal amount of debt financing for the firm because of the additional bankruptcy risk higher levels of debt engender. I test FH’s theory and find evidence that supports it. Specifically, the amount of debt in our sample firms’ capital structures declines as the percentage of the firm’s common stock held by the CEO and other officers and directors increases. A direct relationship is found between blockholder share ownership and our sample firms’ debt/equity ratio. This suggests that monitoring by blockholders is effective in controlling the suboptimal debt usage agency problem. Further, for any given level of blockholder share ownership, the greater the number of blockholders a firm has the less effective blockholders are in raising the amount of debt in the firm’s capital structure. Lastly, some weak evidence was found suggesting that a dual leadership structure was effective in increasing the amount of debt in a firm’s capital structure.

Publications from industry. Personal and corporate incentives.

Industry scientists are often asked by their colleagues from academia why they do not publish more. The caricature, it seems, is of an active and productive industry generating lots of data that could be of benefit to the scientific community and yet keeping them all under wraps for various purposes

The Humanization of Lawyers

This article focus on a significant recent transformation that has occurred in the legal profession: the growing recognition that lawyers suffer from ordinary human failings. Society and professional regulators have tended to hold lawyers to a uniquely high standard of citizenship. Lawyers have been held responsible for avoiding personal incentives, natural psychological reactions, vices, and crime to a far greater extent than private citizens and other businesspersons. This article suggests that the fiction that lawyers are, or can be regulated into being, more upstanding than laypersons has begun to break down, with significant ramifications for the bar. The humanization phenomenon has resulted in changing treatment of the bar, both in leading to a greater tolerance for lawyer vices (e.g., substance abuse) and resulting in more frequent prosecution and punishment for ordinary misconduct. This article discusses some of the other ramifications of the humanization of lawyers, including changes in the structure of law practice, the substance of lawyer regulation, the focus of bar programs, and the identities of who regulates lawyers. Identifying these changes requires regulators to reassess the behavioral incentives they provide in the rules. Recognizing the hard reality about lawyers also enables the profession to deal with its negative image in society on a more honest basis. It may result to increased regulation of the bar in the future, but it may also allow bar regulators to focus more on understanding the needs of lawyers and helping them to find the services that satisfy those needs.

An emerging view of scientific collaboration: Scientists' perspectives on collaboration and factors that impact collaboration

AbstractCollaboration is often a critical aspect of scientific research, which is dominated by complex problems, rapidly changing technology, dynamic growth of knowledge, and highly specialized areas of expertise. An individual scientist can seldom provide all of the expertise and resources necessary to address complex research problems. This paper describes collaboration among a group of scientists, and considers how their experiences are socially shaped. The scientists were members of a newly formed distributed, multi‐disciplinary academic research center that was organized into four multi‐disciplinary research groups. Each group had 14 to 34 members, including faculty, postdoctoral fellows and students, at four geographically dispersed universities. To investigate challenges that emerge in establishing scientific collaboration, data were collected about members' previous and current collaborative experiences, perceptions regarding collaboration, and work practices during the center's first year of operation. The data for the study includes interviews with members of the center, observations of videoconferences and meetings, and a center‐wide sociometric survey. Data analysis has led to the development of a framework that identifies forms of collaboration that emerged among scientists (e.g., complementary and integrative collaboration) and associated factors, which influenced collaboration including personal compatibility, work connections, incentives, and infrastructure. These results may inform the specification of social and organizational practices, which are needed to establish collaboration in distributed, multi‐disciplinary research centers.

Emerging crisis of continuing professional education: becoming a dead letter between external pressure and personal incentive?

Continuing professional education (CPE) has been recognized as an effective tool for equipping health professionals with updated knowledge and skills for improving health services quality. However, there is globally increasing skepticism concerning the effectiveness of CPE. In developed countries, the major reasons for participation in CPE include compliance with employers' requirements and renewal of specialist qualifications and licences. In developing countries, CPE, frequently supported by development agencies, often provides subsistence support to participants and is possibly perceived as an extra income opportunity or tool for promotion among health professionals. The knowledge and skills learned are insufficiently applied in daily practice. This carrot-and-stick approach should be reduced and efforts should be made to increase the level of application of what has been learned. To deliver more effective and efficient CPE, it is critical to study this issue in more depth.