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Discounting and clinical decision making: physicians, patients, the general public, and the management of asymptomatic abdominal aortic aneurysms.

Höjgård, Sören LU ; Enemark, Ulrika; Lyttkens, Carl Hampus LU ; Lindgren, Anna LU ; Troëng, Thomas and Weibull, H (2002) In Health Economics 11(4). p.355-370
Abstract
Clinical decisions often entail in intertemporal trade-off. Moreover, they often involve physicians of different specialities. In an experiment dealing with the management of small asymptomatic abdominal aortic aneurysms (a clinically relevant problem) we find that specialists in internal medicine exhibit higher implicit discount rates than vascular surgeons, general practitioners, and actual and prospective patients. Several personal characteristics expected to be directly related to pure time-preference and risk aversion (gender, smoking habits, age, place of employment) have the hypothesised effects. Additionally, financial incentives appear to affect the estimated implicit discount rates of physicians, but are unlikely to have caused... (More)
Clinical decisions often entail in intertemporal trade-off. Moreover, they often involve physicians of different specialities. In an experiment dealing with the management of small asymptomatic abdominal aortic aneurysms (a clinically relevant problem) we find that specialists in internal medicine exhibit higher implicit discount rates than vascular surgeons, general practitioners, and actual and prospective patients. Several personal characteristics expected to be directly related to pure time-preference and risk aversion (gender, smoking habits, age, place of employment) have the hypothesised effects. Additionally, financial incentives appear to affect the estimated implicit discount rates of physicians, but are unlikely to have caused the inter-group differences. Differences in discount rates could lead to variations in clinical practice, which may conflict with equality of treatment or equal access to health care. Copyright © 2002 John Wiley & Sons, Ltd. (Less)
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keywords
Aged, Vascular Surgical Procedures: utilization, Time Factors, Models, Quality-Adjusted Life Years, Middle Age, Human, Comparative Study, Aortic Aneurysm, Male, Internal Medicine: statistics & numerical data, Decision Making, Abdominal: surgery, Abdominal: mortality, Family Practice: statistics & numerical data, Abdominal: physiopathology, Physician's Practice Patterns: statistics & numerical data, Statistical, Patient Acceptance of Health Care: statistics & numerical data, Questionnaires, Risk Assessment, Support, Non-U.S. Gov't, Sweden: epidemiology, Survival Analysis
in
Health Economics
volume
11
issue
4
pages
355 - 370
publisher
John Wiley & Sons
external identifiers
  • wos:000175873700005
  • scopus:0036264982
ISSN
1099-1050
DOI
10.1002/hec.674
language
English
LU publication?
yes
id
7627fcc2-1ad9-4031-b022-c335dfd62689 (old id 115347)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12007166&dopt=Abstract
date added to LUP
2007-07-12 10:30:58
date last changed
2017-01-01 04:38:17
@article{7627fcc2-1ad9-4031-b022-c335dfd62689,
  abstract     = {Clinical decisions often entail in intertemporal trade-off. Moreover, they often involve physicians of different specialities. In an experiment dealing with the management of small asymptomatic abdominal aortic aneurysms (a clinically relevant problem) we find that specialists in internal medicine exhibit higher implicit discount rates than vascular surgeons, general practitioners, and actual and prospective patients. Several personal characteristics expected to be directly related to pure time-preference and risk aversion (gender, smoking habits, age, place of employment) have the hypothesised effects. Additionally, financial incentives appear to affect the estimated implicit discount rates of physicians, but are unlikely to have caused the inter-group differences. Differences in discount rates could lead to variations in clinical practice, which may conflict with equality of treatment or equal access to health care. Copyright © 2002 John Wiley & Sons, Ltd.},
  author       = {Höjgård, Sören and Enemark, Ulrika and Lyttkens, Carl Hampus and Lindgren, Anna and Troëng, Thomas and Weibull, H},
  issn         = {1099-1050},
  keyword      = {Aged,Vascular Surgical Procedures: utilization,Time Factors,Models,Quality-Adjusted Life Years,Middle Age,Human,Comparative Study,Aortic Aneurysm,Male,Internal Medicine: statistics & numerical data,Decision Making,Abdominal: surgery,Abdominal: mortality,Family Practice: statistics & numerical data,Abdominal: physiopathology,Physician's Practice Patterns: statistics & numerical data,Statistical,Patient Acceptance of Health Care: statistics & numerical data,Questionnaires,Risk Assessment,Support,Non-U.S. Gov't,Sweden: epidemiology,Survival Analysis},
  language     = {eng},
  number       = {4},
  pages        = {355--370},
  publisher    = {John Wiley & Sons},
  series       = {Health Economics},
  title        = {Discounting and clinical decision making: physicians, patients, the general public, and the management of asymptomatic abdominal aortic aneurysms.},
  url          = {http://dx.doi.org/10.1002/hec.674},
  volume       = {11},
  year         = {2002},
}