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

• 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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Keyword

Aged

Vascular Surgical Procedures: utilization

Time Factors

Models

Quality-Adjusted Life Years

Middle Age

Human

Comparative Study

Aortic Aneurysm

Male

Internal Medicine: statistics & numerical data

Decision Making

Abdominal: surgery

Abdominal: mortality

Family Practice: statistics & numerical data

Abdominal: physiopathology

Physician's Practice Patterns: statistics & numerical data

Statistical

Patient Acceptance of Health Care: statistics & numerical data

Questionnaires

Risk Assessment

Support

Non-U.S. Gov't

Sweden: epidemiology

Survival Analysis

Publication and Content Type

art (subject category)

ref (subject category)