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Gac Sanit. 2016 Nov - Dec;30(6):408-414. doi: 10.1016/j.gaceta.2016.04.013. Epub 2016 Jun 16.

Incentives and intrinsic motivation in healthcare.

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Office of Health Economics, London, United Kingdom. Electronic address:
Departamento de Economía, Universidad Pública de Navarra, Pamplona (Navarra), Spain.



It has been established in the literature that workers within public organisations are intrinsically motivated. This paper is an empirical study of the healthcare sector using methods of qualitative analysis research, which aims to answer the following hypotheses: 1) doctors are intrinsically motivated; 2) economic incentives and control policies may undermine doctors' intrinsic motivation; and 3) well-designed incentives may encourage doctors' intrinsic motivation.


We conducted semi-structured interviews à-la-Bewley with 16 doctors from Navarre's Healthcare Service (Servicio Navarro de Salud-Osasunbidea), Spain. The questions were based on current theories of intrinsic motivation and incentives to test the hypotheses. Interviewees were allowed to respond openly without time constraints. Relevant information was selected, quantified and analysed by using the qualitative concepts of saturation and codification.


The results seem to confirm the hypotheses. Evidence supporting hypotheses 1 and 2 was gathered from all interviewees, as well as indications of the validity of hypothesis 3 based on interviewees' proposals of incentives.


The conclusions could act as a guide to support the optimal design of incentive policies and schemes within health organisations when healthcare professionals are intrinsically motivated.


Crowding effects; Efectos de expulsión; Entrevistas; Interviews; Intrinsic motivation; Investigación cualitativa; Motivación intrínseca; Qualitative research

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