IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v11y2002i4p355-370.html
   My bibliography  Save this article

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

Author

Listed:
  • S. Höjgård
  • U. Enemark
  • C. H. Lyttkens
  • A. Lindgren
  • T. Troëng
  • H. Weibull

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.

Suggested Citation

  • S. Höjgård & U. Enemark & C. H. Lyttkens & A. Lindgren & T. Troëng & H. Weibull, 2002. "Discounting and clinical decision making: Physicians, patients, the general public, and the management of asymptomatic abdominal aortic aneurysms," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 355-370, June.
  • Handle: RePEc:wly:hlthec:v:11:y:2002:i:4:p:355-370
    DOI: 10.1002/hec.674
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.674
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.674?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
    ---><---

    References listed on IDEAS

    as
    1. Amiram Gafni & George W. Torrance, 1984. "Risk Attitude and Time Preference in Health," Management Science, INFORMS, vol. 30(4), pages 440-451, April.
    2. Kiefer, Nicholas M, 1988. "Economic Duration Data and Hazard Functions," Journal of Economic Literature, American Economic Association, vol. 26(2), pages 646-679, June.
    3. Eckerlund, Ingemar & Håkansson, Stefan, 1989. "Variations in resource utilization--The role of medical practice and its economic impact," Social Science & Medicine, Elsevier, vol. 28(2), pages 165-173, January.
    4. John A. Cairns, 1994. "Valuing future benefits," Health Economics, John Wiley & Sons, Ltd., vol. 3(4), pages 221-229, July.
    5. John Cairns, 1992. "Discounting and health benefits: Another Perspective," Health Economics, John Wiley & Sons, Ltd., vol. 1(1), pages 76-79, April.
    6. Jianakoplos, Nancy Ammon & Bernasek, Alexandra, 1998. "Are Women More Risk Averse?," Economic Inquiry, Western Economic Association International, vol. 36(4), pages 620-630, October.
    7. Ainslie, George, 1991. "Derivation of "Rational" Economic Behavior from Hyperbolic Discount Curves," American Economic Review, American Economic Association, vol. 81(2), pages 334-340, May.
    8. Donald A. Redelmeier & Daniel N. Heller, 1993. "Time Preference in Medical Decision Making and Cost - Effectiveness Analysis," Medical Decision Making, , vol. 13(3), pages 212-217, August.
    9. Powell, Melanie & Ansic, David, 1997. "Gender differences in risk behaviour in financial decision-making: An experimental analysis," Journal of Economic Psychology, Elsevier, vol. 18(6), pages 605-628, November.
    10. Gretchen B. Chapman & Arthur S. Elstein, 1995. "Valuing the Future," Medical Decision Making, , vol. 15(4), pages 373-386, October.
    11. Horowitz, John K & Carson, Richard T, 1990. "Discounting Statistical Lives," Journal of Risk and Uncertainty, Springer, vol. 3(4), pages 403-413, December.
    12. Cropper, Maureen L & Aydede, Sema K & Portney, Paul R, 1992. "Rates of Time Preference for Saving Lives," American Economic Review, American Economic Association, vol. 82(2), pages 469-472, May.
    13. John A. Cairns & Marjon M. Van Der Pol, 1997. "Saving future lives. A comparison of three discounting models," Health Economics, John Wiley & Sons, Ltd., vol. 6(4), pages 341-350, July.
    14. Cropper, Maureen L & Aydede, Sema K & Portney, Paul R, 1994. "Preferences for Life Saving Programs: How the Public Discounts Time and Age," Journal of Risk and Uncertainty, Springer, vol. 8(3), pages 243-265, May.
    15. Jan Abel Olsen, 1994. "Persons vs years: Two ways of eliciting implicit weights," Health Economics, John Wiley & Sons, Ltd., vol. 3(1), pages 39-46, January.
    16. Olsen, Jan Abel, 1993. "On what basis should health be discounted?," Journal of Health Economics, Elsevier, vol. 12(1), pages 39-53, April.
    17. Lowenstein, George & Prelec, Drazen, 1991. "Negative Time Preference," American Economic Review, American Economic Association, vol. 81(2), pages 347-352, May.
    18. Cairns, John & Van der Pol, Marjon, 1997. "Constant and decreasing timing aversion for saving lives," Social Science & Medicine, Elsevier, vol. 45(11), pages 1653-1659, December.
    19. Jan Abel Olsen, 1993. "Time preferences for health gains: An empirical investigation," Health Economics, John Wiley & Sons, Ltd., vol. 2(3), pages 257-265, October.
    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. Irvine, Alastair & van der Pol, Marjon & Phimister, Euan, 2019. "A comparison of professional and private time preferences of General Practitioners," Social Science & Medicine, Elsevier, vol. 222(C), pages 256-264.
    2. Simon Jean-Baptiste Combes & Alain Paraponaris & Yann Videau, 2019. "French GPs’ Willingness to Delegate Tasks: May Financial Incentives Balance Risk Aversion?," Working Papers halshs-02071522, HAL.

    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. Francis Asenso‐Boadi & Tim J. Peters & Joanna Coast, 2008. "Exploring differences in empirical time preference rates for health: an application of meta‐regression," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 235-248, February.
    2. Arthur E. Attema & Matthijs M. Versteegh, 2013. "Would You Rather Be Ill Now, Or Later?," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1496-1506, December.
    3. Dorte Gyrd‐Hansen & Jes Søgaard, 1998. "Discounting life‐years: whither time preference?," Health Economics, John Wiley & Sons, Ltd., vol. 7(2), pages 121-127, March.
    4. K. Stavem & I. S. Kristiansen & J. A. Olsen, 2002. "Association of time preference for health with age and disease severity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 3(2), pages 120-124, June.
    5. Carl Lyttkens, 2003. "Time to disable DALYs?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 4(3), pages 195-202, September.
    6. John A. Cairns & Marjon M. Van Der Pol, 1997. "Saving future lives. A comparison of three discounting models," Health Economics, John Wiley & Sons, Ltd., vol. 6(4), pages 341-350, July.
    7. John A. Cairns, 1994. "Valuing future benefits," Health Economics, John Wiley & Sons, Ltd., vol. 3(4), pages 221-229, July.
    8. Arthur E. Attema & Han Bleichrodt & Olivier L’Haridon & Patrick Peretti-Watel & Valérie Seror, 2018. "Discounting health and money: New evidence using a more robust method," Journal of Risk and Uncertainty, Springer, vol. 56(2), pages 117-140, April.
    9. Alireza Mahboub-Ahari & Abolghasem Pourreza & Ali Akbari Sari & Trevor A Sheldon & Maryam Moeeni, 2019. "Private and social time preference for health outcomes: A general population survey in Iran," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-13, February.
    10. Bleichrodt, Han & Gafni, Amiram, 1996. "Time preference, the discounted utility model and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 49-66, February.
    11. Angelina Lazaro & Ramon Barberan & Encarnacion Rubio, 2002. "The economic evaluation of health programmes: why discount health consequences more than monetary consequences?," Applied Economics, Taylor & Francis Journals, vol. 34(3), pages 339-350.
    12. Lazaro, Angelina & Barberan, Ramon & Rubio, Encarnacion, 2002. "The discounted utility model and social preferences:: Some alternative formulations to conventional discounting," Journal of Economic Psychology, Elsevier, vol. 23(3), pages 317-337, June.
    13. Kristian Schultz Hansen & Lars Peter Østerdal, 2006. "Models of Quality‐Adjusted Life Years when Health Varies Over Time: Survey and Analysis," Journal of Economic Surveys, Wiley Blackwell, vol. 20(2), pages 229-255, April.
    14. Murray, Christopher J. L. & Acharya, Arnab K., 1997. "Understanding DALYs," Journal of Health Economics, Elsevier, vol. 16(6), pages 703-730, December.
    15. Galizzi, Matteo M. & Miraldo, Marisa & Stavropoulou, Charitini & van der Pol, Marjon, 2016. "Doctor–patient differences in risk and time preferences: A field experiment," Journal of Health Economics, Elsevier, vol. 50(C), pages 171-182.
    16. McDonald, R.L. & Chilton, S.M. & Jones-Lee, M.W. & Metcalf, H.R.T., 2017. "Evidence of variable discount rates and non-standard discounting in mortality risk valuation," Journal of Environmental Economics and Management, Elsevier, vol. 82(C), pages 152-167.
    17. Marjon Pol & Larissa Roux, 2005. "Time preference bias in time trade-off," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(2), pages 107-111, June.
    18. Vasquez-Lavín, Felipe & Ponce Oliva, Roberto D. & Hernández, José Ignacio & Gelcich, Stefan & Carrasco, Moisés & Quiroga, Miguel, 2019. "Exploring dual discount rates for ecosystem services: Evidence from a marine protected area network," Resource and Energy Economics, Elsevier, vol. 55(C), pages 63-80.
    19. Jeffery L. Guyse & L. Robin Keller & Candice H. Huynh, 2020. "Valuing Sequences of Lives Lost or Saved Over Time: Preference for Uniform Sequences," Decision Analysis, INFORMS, vol. 17(1), pages 24-38, March.
    20. Guyse, Jeffery L. & Keller, L. Robin & Eppel, Thomas, 2002. "Valuing Environmental Outcomes: Preferences for Constant or Improving Sequences," Organizational Behavior and Human Decision Processes, Elsevier, vol. 87(2), pages 253-277, March.

    More about this item

    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:wly:hlthec:v:11:y:2002:i:4:p:355-370. 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: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    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.