IDEAS home Printed from https://ideas.repec.org/a/aea/aerins/v4y2022i4p507-26.html
   My bibliography  Save this article

A Taste of Their Own Medicine: Guideline Adherence and Access to Expertise

Author

Listed:
  • Amy Finkelstein
  • Petra Persson
  • Maria Polyakova
  • Jesse M. Shapiro

Abstract

We use administrative data from Sweden to study adherence to 63 medication-related guidelines. We compare the adherence of patients without personal access to medical expertise to that of patients with access, namely doctors and their close relatives. We estimate that observably similar patients with access to expertise have 3.8 percentage points lower adherence, relative to a baseline adherence rate of 54.4 percent among those without access. Our findings suggest an important role in nonadherence for factors other than those, such as ignorance, poor communication, and complexity, that would be expected to diminish with access to expertise.

Suggested Citation

  • Amy Finkelstein & Petra Persson & Maria Polyakova & Jesse M. Shapiro, 2022. "A Taste of Their Own Medicine: Guideline Adherence and Access to Expertise," American Economic Review: Insights, American Economic Association, vol. 4(4), pages 507-526, December.
    • Handle: RePEc:aea:aerins:v:4:y:2022:i:4:p:507-26
    DOI: 10.1257/aeri.20210591
    as

    Download full text from publisher

    File URL: https://www.aeaweb.org/doi/10.1257/aeri.20210591
    Download Restriction: no
    File URL: https://www.aeaweb.org/doi/10.1257/aeri.20210591.appx
    Download Restriction: no
    File URL: https://www.aeaweb.org/doi/10.1257/aeri.20210591.ds
    Download Restriction: Access to full text is restricted to AEA members and institutional subscribers.
    File URL: https://libkey.io/10.1257/aeri.20210591?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Katherine Baicker & Sendhil Mullainathan & Joshua Schwartzstein, 2015. "Behavioral Hazard in Health Insurance," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(4), pages 1623-1667.
    2. Persson, Petra & Chen, Yiqun & Polyakova, Maria, 2019. "The Roots of Health Inequality and the Value of Intra-Family Expertise," CEPR Discussion Papers 13583, C.E.P.R. Discussion Papers.
    3. Emily Cuddy & Janet Currie, 2020. "Rules vs. Discretion: Treatment of Mental Illness in U.S. Adolescents," NBER Working Papers 27890, National Bureau of Economic Research, Inc.
    4. Janet M. Currie & W. Bentley MacLeod, 2020. "Understanding Doctor Decision Making: The Case of Depression Treatment," Econometrica, Econometric Society, vol. 88(3), pages 847-878, May.
    5. Bodnaruk, Andriy & Simonov, Andrei, 2015. "Do financial experts make better investment decisions?," Journal of Financial Intermediation, Elsevier, vol. 24(4), pages 514-536.
    6. Elisabeth Artmann & Hessel Oosterbeek & Bas van der Klaauw, 2022. "Do Doctors Improve the Health Care of Their Parents? Evidence from Admission Lotteries," American Economic Journal: Applied Economics, American Economic Association, vol. 14(3), pages 164-184, July.
    7. Frakes, Michael & Gruber, Jonathan & Jena, Anupam, 2021. "Is great information good enough? Evidence from physicians as patients," Journal of Health Economics, Elsevier, vol. 75(C).
    8. Leuven, Edwin & Oosterbeek, Hessel & de Wolf, Inge, 2013. "The effects of medical school on health outcomes: Evidence from admission lotteries," Journal of Health Economics, Elsevier, vol. 32(4), pages 698-707.
    9. Bart J. Bronnenberg & Jean-Pierre Dubé & Matthew Gentzkow & Jesse M. Shapiro, 2015. "Do Pharmacists Buy Bayer? Informed Shoppers and the Brand Premium," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(4), pages 1669-1726.
    10. Steven D. Levitt & Chad Syverson, 2008. "Market Distortions When Agents Are Better Informed: The Value of Information in Real Estate Transactions," The Review of Economics and Statistics, MIT Press, vol. 90(4), pages 599-611, November.
    11. Erin M. Johnson & M. Marit Rehavi, 2016. "Physicians Treating Physicians: Information and Incentives in Childbirth," American Economic Journal: Economic Policy, American Economic Association, vol. 8(1), pages 115-141, February.
    12. Basu, Anirban, 2011. "Economics of individualization in comparative effectiveness research and a basis for a patient-centered health care," Journal of Health Economics, Elsevier, vol. 30(3), pages 549-559, May.
    13. Benjamin R. Handel & Jonathan T. Kolstad, 2015. "Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare," American Economic Review, American Economic Association, vol. 105(8), pages 2449-2500, August.
    14. Jason Abaluck & Leila Agha & David C. Chan Jr & Daniel Singer & Diana Zhu, 2020. "Fixing Misallocation with Guidelines: Awareness vs. Adherence," NBER Working Papers 27467, National Bureau of Economic Research, Inc.
    15. Rutherford, R.C. & Springer, T.M. & Yavas, A., 2005. "Conflicts between principals and agents: evidence from residential brokerage," Journal of Financial Economics, Elsevier, vol. 76(3), pages 627-665, June.
    16. Grytten, Jostein & Skau, Irene & Sørensen, Rune, 2011. "Do expert patients get better treatment than others? Agency discrimination and statistical discrimination in obstetrics," Journal of Health Economics, Elsevier, vol. 30(1), pages 163-180, January.
    17. Kennedy, J. & Erb, C., 2002. "Prescription noncompliance due to cost among adults with disabilities in the United States," American Journal of Public Health, American Public Health Association, vol. 92(7), pages 1120-1124.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Chen, Stacey H. & Chen, Jennjou & Chuang, Hongwei & Lin, Tzu-Hsin, 2023. "Physicians Treating Physicians: Relational and Informational Advantages in Treatment and Survival," IZA Discussion Papers 16048, Institute of Labor Economics (IZA).
    2. Jena, Anupam B. & Slusky, David & Springer, Lilly, 2023. "Occupational Hazard? An Analysis of Birth Outcomes among Physician Mothers," IZA Discussion Papers 16655, Institute of Labor Economics (IZA).
    3. Amanda Dahlstrand, 2022. "Defying distance? The provision of services in the digital age," CEP Discussion Papers dp1889, Centre for Economic Performance, LSE.
    4. Humlum, Maria Knoth & Morthorst, Marius Opstrup & Thingholm, Peter Rønø, 2024. "Sibling spillovers and the choice to get vaccinated: Evidence from a regression discontinuity design," Journal of Health Economics, Elsevier, vol. 94(C).
    5. Frank A. Sloan, 2024. "Subjective beliefs, health, and health behaviors," Journal of Risk and Uncertainty, Springer, vol. 69(2), pages 105-144, October.
    6. Dahlstrand Rudin, Amanda, 2022. "Defying distance? The provision of services in the digital age," LSE Research Online Documents on Economics 118042, London School of Economics and Political Science, LSE Library.
    7. Greve, Jane & Kristensen, Søren Rud & Lydiksen, Nis, 2023. "Patient and peer: Guideline design and expert response," Journal of Health Economics, Elsevier, vol. 92(C).
    8. Nicole Black & David W. Johnston & Martin Knapp & Michael A. Shields & Gloria H.Y. Wong, 2024. "Horizontal inequity in the use of mental healthcare in Australia," Papers 2024-14, Centre for Health Economics, Monash University.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Chen, Stacey H. & Chen, Jennjou & Chuang, Hongwei & Lin, Tzu-Hsin, 2023. "Physicians Treating Physicians: Relational and Informational Advantages in Treatment and Survival," IZA Discussion Papers 16048, Institute of Labor Economics (IZA).
    2. Frakes, Michael & Gruber, Jonathan & Jena, Anupam, 2021. "Is great information good enough? Evidence from physicians as patients," Journal of Health Economics, Elsevier, vol. 75(C).
    3. Erin M. Johnson & M. Marit Rehavi, 2016. "Physicians Treating Physicians: Information and Incentives in Childbirth," American Economic Journal: Economic Policy, American Economic Association, vol. 8(1), pages 115-141, February.
    4. Jena, Anupam B. & Slusky, David & Springer, Lilly, 2023. "Occupational Hazard? An Analysis of Birth Outcomes among Physician Mothers," IZA Discussion Papers 16655, Institute of Labor Economics (IZA).
    5. Elisabeth Artmann & Hessel Oosterbeek & Bas van der Klaauw, 2022. "Do Doctors Improve the Health Care of Their Parents? Evidence from Admission Lotteries," American Economic Journal: Applied Economics, American Economic Association, vol. 14(3), pages 164-184, July.
    6. Hunt Allcott & Benjamin B Lockwood & Dmitry Taubinsky, 2019. "Regressive Sin Taxes, with an Application to the Optimal Soda Tax," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(3), pages 1557-1626.
    7. Hunt Allcott & Benjamin B. Lockwood & Dmitry Taubinsky, 2019. "Should We Tax Sugar-Sweetened Beverages? An Overview of Theory and Evidence," Journal of Economic Perspectives, American Economic Association, vol. 33(3), pages 202-227, Summer.
    8. Greve, Jane & Kristensen, Søren Rud & Lydiksen, Nis, 2023. "Patient and peer: Guideline design and expert response," Journal of Health Economics, Elsevier, vol. 92(C).
    9. Jason Abaluck & Giovanni Compiani, 2020. "A Method to Estimate Discrete Choice Models that is Robust to Consumer Search," NBER Working Papers 26849, National Bureau of Economic Research, Inc.
    10. Zhaohui Li & Qiang Li & Hua Sun & Li Sun, 2022. "Diffused effort, asset heterogeneity, and real estate brokerage," Real Estate Economics, American Real Estate and Urban Economics Association, vol. 50(3), pages 707-742, September.
    11. Hamilton Fout & Nuno Mota & Eric Rosenblatt, 2022. "When Appraisers Go Low, Contracts Go Lower: The Impact of Expert Opinions on Transaction Prices," The Journal of Real Estate Finance and Economics, Springer, vol. 65(3), pages 451-491, October.
    12. Martin Gaynor & Kate Ho & Robert J. Town, 2015. "The Industrial Organization of Health-Care Markets," Journal of Economic Literature, American Economic Association, vol. 53(2), pages 235-284, June.
    13. Glenn Boyle & Graeme Guthrie & Luke Gorton, 2010. "Holding onto Your Horses: Conflicts of Interest in Asset Management," Journal of Law and Economics, University of Chicago Press, vol. 53(4), pages 689-713.
    14. Marcus T. Allen & Justin D. Benefield & Christopher L. Cain & Norman Maynard, 2024. "Distressed Property Sales: Differences and Similarities Across Types of Distress," The Journal of Real Estate Finance and Economics, Springer, vol. 68(2), pages 318-353, February.
    15. Simon Loertscher & Andras Niedermayer, 2007. "When is Seller Price Setting with Linear Fees Optimal for Intermediaries?," Diskussionsschriften dp0706, Universitaet Bern, Departement Volkswirtschaft.
    16. Gautier, Pieter & Siegmann, Arjen & van Vuuren, Aico, 2023. "Real-estate agent commission structure and sales performance," Journal of Empirical Finance, Elsevier, vol. 72(C), pages 163-187.
    17. Werbeck, Anna & Wübker, Ansgar & Ziebarth, Nicolas R., 2021. "Cream skimming by health care providers and inequality in health care access: Evidence from a randomized field experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 188(C), pages 1325-1350.
    18. Bart J. Bronnenberg & Jean-Pierre Dubé & Matthew Gentzkow & Jesse M. Shapiro, 2015. "Do Pharmacists Buy Bayer? Informed Shoppers and the Brand Premium," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(4), pages 1669-1726.
    19. Ronald Rutherford & Thomas Springer & Abdullah Yavas, 2007. "Evidence of Information Asymmetries in the Market for Residential Condominiums," The Journal of Real Estate Finance and Economics, Springer, vol. 35(1), pages 23-38, July.
    20. Jia Xie, 2019. "The Optimal Selling Strategy of Residential Real Estate," The Journal of Real Estate Finance and Economics, Springer, vol. 59(3), pages 461-489, October.

    More about this item

    JEL classification:

    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:aea:aerins:v:4:y:2022:i:4:p:507-26. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Michael P. Albert (email available below). General contact details of provider: https://edirc.repec.org/data/aeaaaea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.