Author
Listed:
- Joan Costa-i-Font
(London School of Economics and Political Science)
- Georgiana Miler-Raicu
(Inselspital, University Hospital Bern)
- Elena Arbelo
(University of Barcelona
Institut d’Investigació August Pi i Sunyer (IDIBAPS)
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)
European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart - ERN GUARD-Heart)
- Ruben Casado-Arroyo
(H.U.B.-Hôpital Erasme, Université Libre de Bruxelles)
- Aya Sami
(London School of Economics and Political Science)
- Eric Wei Seong Tee
(London School of Economics and Political Science)
- Joseph Hazel
(London School of Economics and Political Science)
- Laurent Roten
(Inselspital, University Hospital Bern)
- Tobias Reichlin
(Inselspital, University Hospital Bern)
- Haran Burri
(University Hospital of Geneva)
- Khaled Albouaini
(Royal Liverpool University Hospital)
- Nikola Kozhuharov
(Inselspital, University Hospital Bern
Institut d’Investigació August Pi i Sunyer (IDIBAPS)
Liverpool Heart and Chest Hospital NHS Foundation Trust
University of Basel)
Abstract
Aims Heart failure is a leading cause of hospitalisation in patients over 50, significantly impacting both quality of life and survival. Despite the well-established benefits of Cardiac Resynchronisation Therapy (CRT), its utilisation in clinical practice remains suboptimal. Traditional incentives, have shown limited effectiveness in increasing CRT referrals. This manuscript explores how behavioural economics can offer a novel framework for improving CRT uptake by leveraging behavioural incentives, particularly choice architecture and social incentives, to influence physician referral patterns. Methods and results We underscore key concepts of behavioural economics, including choice architecture (nudges, reference points, sludges), cognitive biases (status quo bias, overconfidence bias, availability bias), and social incentives, which are applied in designing incentives to promote CRT referrals. A survey was conducted with 51 physicians from six European countries, including electrophysiologists, heart failure specialists, and general cardiologists, recruited through cardiology networks and personal contacts. Participants rated their perceptions of five incentive strategies using a Likert scale (1–5). Behavioural incentives, such as peer comparison through league tables (social incentive) and decision prompts in electronic health records (choice architecture nudge), were perceived as more effective than traditional financial incentives, with a median Likert score of 4.0 [IQR 3.0–5.0] versus 2.5 [IQR 1.5–3.0] for traditional incentives (p
Suggested Citation
Joan Costa-i-Font & Georgiana Miler-Raicu & Elena Arbelo & Ruben Casado-Arroyo & Aya Sami & Eric Wei Seong Tee & Joseph Hazel & Laurent Roten & Tobias Reichlin & Haran Burri & Khaled Albouaini & Nikol, 2025.
"Behavioural insights in the underuse of cardiac resynchronisation therapy in heart failure: a pilot survey on incentive perceptions among referring cardiologists,"
Health Economics Review, Springer, vol. 15(1), pages 1-14, December.
Handle:
RePEc:spr:hecrev:v:15:y:2025:i:1:d:10.1186_s13561-025-00657-0
DOI: 10.1186/s13561-025-00657-0
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