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Discounting and clinical decision making: Physicians, patients, the general public, and the management of asymptomatic abdominal aortic aneurysms
Author(s) -
Höjgård S.,
Enemark U.,
Lyttkens C. H.,
Lindgren A.,
Troëng T.,
Weibull H.
Publication year - 2002
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.674
Subject(s) - asymptomatic , discounting , medicine , incentive , preference , time preference , affect (linguistics) , risk aversion (psychology) , psychology , finance , surgery , economics , expected utility hypothesis , microeconomics , financial economics , communication
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.