Standard theories of health provider behavior suggest that providers are motivated by both profit and an altruistic interest in patient health benefit. Detailed empirical data are seldom available to measure relative preferences between profit and patient health outcomes. Furthermore, it is difficult to empirically assess how these relative preferences affect quality of care. This study uses a unique dataset from rural Myanmar to assess heterogeneous preferences toward treatment efficacy relative to provider profit and the impact of these preferences on the quality of provider diagnosis and treatment. Using conjoint survey data from 187 providers, we estimated the marginal utilities of higher treatment efficacy and of higher profit, and the marginal rate of substitution between these outcomes. We also measured the quality of diagnosis and treatment for malaria among these providers using a previously validated observed patient simulation. There is substantial heterogeneity in providers’ utility from treatment efficacy versus utility from higher profits. Higher marginal utility from treatment efficacy is positively associated with the quality of treatment among providers, and higher marginal utility from profit are negatively associated with quality of diagnosis. We found no consistent effect of the ratio of marginal utility of efficacy vs marginal utility of profit on quality of care. Our findings suggest that providers vary in their preferences towards profit and treatment efficacy, with those providers that place greater weight on treatment efficacy providing higher quality of care.

健康提供者行为的标准理论表明，提供者的动机是利润和对患者健康利益的利他利益。很少有详细的经验数据可用于衡量利润与患者健康结果之间的相对偏好。此外，很难凭经验评估这些相对偏好如何影响护理质量。本研究使用来自缅甸农村的独特数据集来评估相对于提供者利润的治疗效果的异质偏好以及这些偏好对提供者诊断和治疗质量的影响。使用来自 187 家提供者的联合调查数据，我们估计了更高治疗效果和更高利润的边际效用，以及这些结果之间的边际替代率。我们还使用先前经过验证的观察到的患者模拟测量了这些提供者的疟疾诊断和治疗质量。提供者在治疗效果方面的效用与更高利润的效用之间存在很大的异质性。较高的治疗效果边际效用与提供者的治疗质量呈正相关，较高的利润边际效用与诊断质量呈负相关。我们发现疗效的边际效用与利润的边际效用之比对护理质量没有一致的影响。我们的研究结果表明，提供者对利润和治疗效果的偏好各不相同，那些更重视治疗效果的提供者提供更高质量的护理。