Investigating the Direct and Spillover Effects of Patient-gifting in Chinese Healthcare: An Online Field Experiment

Description

Patient giving gifts to health professionals is an age-old custom in China. Gifts are typically in the form of cash or symbolic items that have little monetary value (e.g., Chiu et al., 2007). Patient-gifting has become an extremely controversial issue in China. There is a growing concern that health professionals receiving gifts from patients compromises their professional ethics and the fairness of medical practice (Caddell & Hazelton, 2013; Liaropoulos et al., 2008). Furthermore, the prevalence of gifting increases the economic and social costs of the healthcare system.Given this background, this project proposes to examine the direct and spillover effects of patient-gifting on the quality of the medical service provided by the gift-receiving doctors. Specifically, we are interested in testing after a patient gives a gift to a doctor, whether this doctor will provide better (or worse) service to the gift-giving patient and to other patients who do not gift. We examine two common forms of gifts: monetary (e.g., cash) and symbolic (e.g., a thank you letter or other items that have little monetary value) gifts. To address our research question, we propose to run a field experiment on a leading online Chinese medical consultation platform. We will “simulate” patients by creating patient accounts on the online consultation platform. We will then randomly manipulate the gifts given by these simulated patients to doctors and measure the quality of service provided by the doctors to the gift-giving and non-gift-giving patients. Our project seeks to provide a theoretically informed and empirically supported account for the effects of patient-gifting on the quality of medical service. We hope our project can also generate important insights to inform the policies regarding patient-gifting in healthcare.