Minor - Week 5 Flashcards
Diagnostic biases
- Conformation bias
- Hindsight bias
- overconfidence bias
Conformation bias
Tendency to seek and interpret evidence in favour of our hypothesis
- Search for positive evidence in stead of falsification
- Overweighting positive evidence
Hindsight bias
The tendency to believe that a past event was more predictable than it actually was
- We knew al along
- Exaggerate predictability of past eventss
Hindsight bias cons
- limits our ability to learn
Overconfidence
Situation where people own belief in ability is greater than it actual is.
- Subjective vs objective
- Case of more confident, but objectivly not
- Protects self esteem
treatment biases in provider care
- Projection bias
- ## Decoy effects
projection bias
project our current preferences onto point in the future when they should be irrelevant
- Hot gold gap
Vb; Patients decisions in extreme pain not project preferences without pain
Decoy effect
Use of non attractive alternatives to point where people change their preference
- Price quantity
- adding inferior option
- 2 options add in front of after
liability and bias
Providers decision making may be biased, because they try to avooid legal liability in case of error
- Omission (not doing anything)
liability and bias can lead to?
- Extra risks (extra tests and false positives)
- Unnecessary costs
Defensive medicine
Ordering treatments, test and procedures to help protect PA from liability rather than further the diagnosis or treatment of the patient
Conflict of interest providers because
- Finance tech
- Invested in therapies
- Received research funding
- received non financial support
Why do physicians even accept gifts from pharmaceutical industry?
- Entitlement (lóreal effect); they deserve it, especially when they are poorer
- Invulnerability; Doenst affect their medical recommendations
What to do against interest?
Conflict of interest statements; Col statements
- Disclose interest of potential conflict in advance of advice
- Patients should discount advice from providers with interests
Backfiring of conflict of interest statements
- Moral licensing; Disclosed so don’t have to feel guilty (providers)
- Insinuation anxiety; ‘If I don’t take my specialists’ advice then no trust (patient)
Problems on the healthcare market
- Overconsumption of medical services ( moral hazard)
- Information asymmetry (supplier induced demand, adverse selection)
Information asymmetry
- Patients can not judge if provider did the correct diagnosis from symptoms
- Patients will not be able to judge if the PA treatment is optimal for their condition
(require additional information, unlikely is is treated and no costs)
Providers information about
health of patient
I adequate treatment method
I payment of own work
I own competence/ skill
Credance goods
A credence good is a product or service where it’s hard for the customer to know the quality or if it’s really needed, even after they’ve used it, like with medical treatments or car repairs
- Hard to know the quality or if its really needed
credance goods characteristics
- Experts have informational advantage
- Consumers do not observe quality
- Consumers at risk of being overcharged and overserviced
supplier induced demand
Occurs if docters use treatment methods and intensities for treatment, that the patient, if she/he would have the same information as doctor would not choose
credance goods markets three inefficiancies
- Underprovision; recieved less complex treatment
- Overprovision; simple intervention needed but recieves a complex intervention
- Overcharging; simple intervention but charged for the complex one, not to trace if the patient has no information about service and quaility
Sort of payments
- FFS; overprovision risk
- integral payment
- Capitation; undertreatment risk
- Mixed payments and pay for performance
Altruistic physician’s response to incentives
Own benefit and benefit doctor self; trade of benefit patients and doctor self
- FFS; incentivizes overprovision
- CAP; induces underprovision
