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

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  • 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.

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  • 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
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    References listed on IDEAS

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    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.
    3. Stefan A. Lipman & Arthur E. Attema, 2024. "A systematic review of unique methods for measuring discount rates," Journal of Risk and Uncertainty, Springer, vol. 69(2), pages 145-189, October.

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