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
Altruistic physician’s
At beginning of study altruism high
- Becomes less in college
- Practical year becomes more, see the benefits of patients
Other factors that affects Altruistic decision making physician’s
- Skills and expiernce
- habits
- heuristics
- status quo
- comperisons and peer feedback
- intteruptions and time pressure
- information
Solutions to altruism enhancer
- Peer accountability
- defaults
- social norms
- feedback
Altruism
Altruism in healthcare refers to a doctor’s motivation to prioritize the well-being of their patients over their own interests
adherence vs compliance
How well a person follows a healthcare provider’s advice, such as taking medication, following a diet, or making lifestyle changes.
- adherence; voluntary component
- Compliance; almost forced to comply with adherence
adherence measure
Subjective
Physicians; overestimate
- Patients; accurate non adherence, adherence overestimated
Objective
cons of non adherence
- costly
- increased health risks
- target the poorer
Non adherence differentate
- Intentional
- Unintentional
reasons for unintentional non-adherence
- no reminders
- financial reasons
- no sufficient information (but gap between intention and behavior)
reasons for intentional non-adherence
- Side effects
improve adherence with
- Information; tailored to health literacy
- Incentives; lottery for medication adherence
- pricing/ regulation; price drop from 10 to zero
- feedback; daily reports; after effect disappears (behavioral)!
sleep stages and benefits
- Health benefits; NREM stage (immune and growth)
- Brain health; REM (memory and learning)
reasons for efficient sleep
- Bedtime procastination
- sleep hygiene
- low self control
bedtime procastination
Postponing bedtime
- Not enough self control to go to bed
eveningness individual,
- sleep hygiene
specific set of behavior that conflicts with going to bed
- excercising
- video gaming
How to improve sleep
- Pricing and regulation; school time as example (later school times better developmental outcomes)
- Incentivizing; fitbit and payment
- information; more sleepknowlegde, more sleep hygiene. No sleep improvements
- m health; gain and loss framed incentives for sleep (behavioral)!
difference between incentives and pricing/regulation
- Regulation and pricing targets both producers and consumers; through pricing mechanism
- Incentives only consumer; not changing the price
5 A model of acceptance (for vaccination uptake)
- Access (the people reached)
- Affordability (both financial and non financial eg side effects)
- Awareness ( knowledge for need, objective benefits and risks)
- Acceptance (degree of acceptance, question or refuse)
- Activation ( degree of nudging towards vaccination)
historically anti vaccinations
Tend to be driven by beliefs (made for profit, illness and disorders, immunity is temporary)
- Disinformation leads to hesitancy
- Social institutions distrust
Target group; people with migration background and suburban states (faith, bible belt); less accessible and affordability
determinants of vaccine decision making
Information
- Campaigns
- education
- media
Risk perceptions
- risk of infection; affective and cognitive
- RIsk of vaccine adverse effects; affective and cognitive
Modyfing factors;
- Injunctive norms (what you should do)
- Descriptive norms (what others do)
- attitude
- habit
- barriers
Leads to intention
determinants of vaccine decision making - WHO
Starts from intention
Thinking and feeling (risk perception)
Social processes (norms )
Motivation
modifying; practical issues (5 A - accessibility, affordability)
vaccination
Why not vaccinate - 4 C model
- Complacency
- Convenience
-Confidence - Calculation
Why not vaccinate - 4 C model - Complacency
Low risk of percieved risk; contradicts probability weightening
- underestimation of people who do vaccinate
Not seen as an necessary preventive action
Why not vaccinate - 4 C model - convenience
structural barriers
- availability
- affordability
- ability
Why not vaccinate - 4 C model - confidence
trust in
- effectiveness
- system that delivers vaccination
- choice architect
Why not vaccinate - 4 C model - calculation
- Free riding; rational decision to not vaccinate, because of positive externalities of others
anchoring effect in vaccination
- Relying on disinformation of numerical for decision about decision to vaccinate
Importance factors deciding to vaccinate
- Social norms
- Knowings risks and beneifts
- Messages social media
- Option to choose
- Advice of health provider
examples interventions for uptake
- Disinformation countering
- Mobile units
