IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/29356.html

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 non-adherence 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, 2021. "A Taste of Their Own Medicine: Guideline Adherence and Access to Expertise," NBER Working Papers 29356, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:29356
    Note: AG CH EH PE LS
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w29356.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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).
    6. Yiqun Chen & Petra Persson & Maria Polyakova, 2019. "The Roots of Health Inequality and The Value of Intra-Family Expertise," NBER Working Papers 25618, National Bureau of Economic Research, Inc.
    7. 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.
    8. 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.
    9. 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.
    10. 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.
    11. 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.
    12. 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.
    13. 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.
    14. Bodnaruk, Andriy & Simonov, Andrei, 2015. "Do financial experts make better investment decisions?," Journal of Financial Intermediation, Elsevier, vol. 24(4), pages 514-536.
    15. Emily Cuddy & Janet Currie, 2020. "Rules vs. Discretion: Treatment of Mental Illness in U.S. Adolescents," Working Papers 2020-10, Princeton University. Economics Department..
    16. 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.
    17. 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.
    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. Nicole Black & David W. Johnston & Martin Knapp & Michael A. Shields & Gloria H. Y. Wong, 2025. "Horizontal inequity in the use of mental healthcare in Australia," Health Economics, John Wiley & Sons, Ltd., vol. 34(2), pages 297-315, February.
    2. Greve, Jane & Kristensen, Søren Rud & Lydiksen, Nis, 2023. "Patient and peer: Guideline design and expert response," Journal of Health Economics, Elsevier, vol. 92(C).
    3. 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).
    4. 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.
    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. 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).
    7. Anupam Jena & David Slusky & Lilly Springer, 2023. "Occupational Hazard? An Analysis of Birth Outcomes Among Physician Mothers," NBER Working Papers 31955, National Bureau of Economic Research, Inc.
    8. Persson, Ulf & Geoffard, Pierre-Yves & Möller, Jörgen & Brådvik, Gunnar, 2025. "An analysis of behaviour, health, and GDP during the Covid-19 pandemic in Europe," IHE Report / IHE Rapport 2025:1, IHE - The Swedish Institute for Health Economics.
    9. Amanda Dahlstrand, 2022. "Defying distance? The provision of services in the digital age," CEP Discussion Papers dp1889, Centre for Economic Performance, LSE.
    10. Albertini, Mattia & Bakx, Pieter & Mazzonna, Fabrizio, 2025. "Health and Labor Market Consequences of Low-Value Care: The Role of Practice Style," IZA Discussion Papers 17771, Institute of Labor Economics (IZA).
    11. Pragya Kakani & Simone Matecna & Amitabh Chandra, 2025. "Expert Patients’ Use of Avoidable Health Care," NBER Working Papers 33573, National Bureau of Economic Research, Inc.

    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. 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.
    5. Greve, Jane & Kristensen, Søren Rud & Lydiksen, Nis, 2023. "Patient and peer: Guideline design and expert response," Journal of Health Economics, Elsevier, vol. 92(C).
    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. Anupam Jena & David Slusky & Lilly Springer, 2023. "Occupational Hazard? An Analysis of Birth Outcomes Among Physician Mothers," NBER Working Papers 31955, National Bureau of Economic Research, Inc.
    8. 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.
    9. 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.
    10. 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.
    11. 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.
    12. Oded Palmon & Ben J. Sopranzetti, 2017. "On the relationship between the number of a broker’s real estate listings and transaction outcomes," Review of Quantitative Finance and Accounting, Springer, vol. 49(1), pages 65-89, July.
    13. Lu Han & William C. Strange, 2014. "Bidding Wars for Houses," Real Estate Economics, American Real Estate and Urban Economics Association, vol. 42(1), pages 1-32, March.
    14. Geoffrey K. Turnbull & Bennie D. Waller & Scott A. Wentland, 2022. "Mitigating agency costs in the housing market," Real Estate Economics, American Real Estate and Urban Economics Association, vol. 50(3), pages 829-861, September.
    15. Simon Loertscher & Andras Niedermayer, 2012. "Fee-Setting Mechanisms: On Optimal Pricing by Intermediaries and Indirect Taxation," Department of Economics - Working Papers Series 1162, The University of Melbourne.
    16. Nathaniel Hendren & Camille Landais & Johannes Spinnewijn, 2021. "Choice in Insurance Markets: A Pigouvian Approach to Social Insurance Design," Annual Review of Economics, Annual Reviews, vol. 13(1), pages 457-486, August.
    17. Brunella Bruno & Emilia Garcia‐Appendini & Giacomo Nocera, 2018. "Experience and Brokerage in Asset Markets: Evidence from Art Auctions," Financial Management, Financial Management Association International, vol. 47(4), pages 833-864, December.
    18. Martijn Dröes & Philip Koppels & Boris Ziermans, 2017. "Information Asymmetry, Lease Incentives, and the Role of Advisors in the Market for Commercial Real Estate," ERES eres2017_250, European Real Estate Society (ERES).
    19. Lawrence Kryzanowski & Yanting Wu & Tingyu Zhou, 2023. "Conflicts of interest and agent heterogeneity in buyer brokerage," Real Estate Economics, American Real Estate and Urban Economics Association, vol. 51(1), pages 130-169, January.
    20. Velma Zahirovic-Herbert & Bennie D. Waller & Geoffrey K. Turnbull, 2020. "Properties that Sell at or above Listing Price: Strategic Pricing, Better Broker or Just Dumb Luck?," The Journal of Real Estate Finance and Economics, Springer, vol. 60(1), pages 53-76, February.

    More about this item

    JEL classification:

    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:nbr:nberwo:29356. 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: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.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.