Experimental Studies on Motivation and Performance
Creators: name: Hendijani, Rosa
Publisher: name: Graduate Studies
Year: 2013
Subjects: subject: Management
subject: motivation
subject: Performance
subject: referral process
subject: intrinsic motivation
subject: extrinsic motivation
subject: primary care
subject: social relationships

description: This dissertation consists of three experimental studies to test the effect of motivational factors, such as monetary rewards and social relationships, on performance in different contexts, such as health care. The three studies can be thought of as a single body of work because they use the same methodology to address different research questions related to motivation and performance. In each study, we designed an experiment to test our hypotheses that were developed based on the related literature on motivation in various contexts, including health care. The first study examined the effect of external reward and intrinsic motivation on overall task motivation and performance, using a laboratory experiment; we used self-selection into an area of knowledge for assessing intrinsic motivation. The results of this experiment provided support for our hypotheses regarding the positive effect of external reward and intrinsic motivation on overall task motivation and performance. In the second and third studies, we focused on motivational factors affecting referral processes in health care systems. The second study examined the effect of social relationships on referral rate. Using an online survey, we examined how a shift from a decentralized referral system, characterized by close relationship between general practitioners and specialists, to a centralized system, in which there is no relationship between the referring general practitioner and the specialist, would affect referral decision making. We found partial support for our hypothesis on the effect of social relationships and referral rate. Medical doctors who had high confidence in their referral decision making referred significantly fewer patients under the close relationship condition in comparison with the centralized referral system. The third study examined the effect of fundholding and pay-for-performance schemes on referral rate and referral appropriateness. While we could not find significant statistical support for our hypotheses, the results were in the direction that we predicted. Both fundholding and pay-for-performance schemes decreased referral rate in comparison with the fixed pay treatment. In addition, pay-for-performance resulted in more appropriate referrals in comparison with fundholding and fixed pay schemes. The dissertation chapters are in the following order: chapter one gives an introduction to the field of motivation and performance. Chapter two provides a literature review of intrinsic-extrinsic motivation. Chapter three presents our first study on the effect of external reward and intrinsic motivation on overall task motivation and performance. Chapter four provides a literature review on the factors affecting referral decision making in healthcare systems. Chapters five and six present the second and third studies on the effect of social relationships and financial schemes on referral patterns respectively. Finally, chapter seven provides concluding remarks regarding the results of our three studies and future research directions.