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Prioriteringar inom vården: Ett beteendeexperiment som undersöker om prioriteringar inom vården påverkas av cost neglect och patientens identifierbarhet
Linköping University, Department of Management and Engineering, Economics.
Linköping University, Department of Management and Engineering, Economics.
2018 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesisAlternative title
Rationing within the healthcare sector : A behavioural experiment that seeks to determine if rationing within the healthcare sector is affected by cost neglect and the patients identifiability (English)
Abstract [sv]

I denna studie undersöker författarna om prioriteringar inom vården påverkas av cost neglect och patienternas identifierbarhet med hjälp av ett beteendeexperiment. Experimentet utförs genom att sex olika enkäter distribueras till ett urval av Sveriges befolkning. Respondenterna randomiseras in i en av experimentgrupperna. Totalt finns sex experimentgrupper, en för varje enkät. 1019 respondenter har deltagit i experimentet, jämt fördelat på de sex experimentgrupperna. Varje enkät innehåller sju olika scenarier som respondenterna ska ta ställning till. Sex av dessa behandlar prioriteringar inom vården där respondenterna ska ta ställning till vilken behandling de vill behandla en patient eller patientgrupp med. Det sjunde scenariot är en replikering, utvidgning och modernisering av Fredericks et al. experiment som utfördes 2009. I replikeringen ska respondenterna ta ställning till om de vill köpa eller inte köpa en mobiltelefon.

Det som skiljer enkäterna åt är olika inramningar. Inramningarna avser att förändra variabler så att det kan undersökas vilken effekt de olika inramningarna har. Variablerna som förändras är patientens identifierbarhet, presentationen av alternativkostnaden samt presentationen av behandlingskostnaden. Utöver scenarierna ställs ett antal kontrollfrågor så som om respondenten upplevde det emotionellt påfrestande att besvara enkäten, respondentens ålder, kön, utbildning och erfarenhet inom hälso- och sjukvården.

Resultaten från experimentet validerar Fredricks et al. studie. Finner få bevis för att cost neglect påverkar beslutfattandet inom vården. Finner att vårdpersonal påverkas av patientens identifierbarhet men inte övriga befolkningen. Slutligen finner studien att typen av behandling, livsavgörande eller livskvalitéförbättrande, har en signifikant påverkan på beslutfattandet där livsavgörande behandlingar prioriteras i en lägre utsträckning än livskvalitéförbättrande.

Abstract [en]

In this study the authors investigate whether healthcare priorities are affected by cost neglect and patient identifiability using a behavioural experiment. The experiment is performed by distributing six different surveys to a sample of Sweden's population. Respondents responding are randomized to one of these surveys. In total there are six experimental groups, one for each survey. 1019 respondents have participated in the experiment, evenly distributed among the six experimental groups. In each of the surveys the respondents’ considered seven different scenarios. Six of these address prioritization in health care where respondents decide on the treatment they want to give a patient or patient group. The seventh scenario is a replication, expansion and modernization of Fredericks et al. experiments conducted in 2009. In the replication the respondents decide if they want to buy or not to buy a mobile phone.

What separates the questionnaires are different frames. The frames aim to change variables so that the authors can investigate the effect of the different frames. The variables that are changing are the patients’ identifiability, the presentation of the opportunity cost and the presentation of the treatment cost. In addition to the scenarios, a number of control questions were asked. Such as how the respondent experienced the questionnaire, the respondent's age, sex, education and experience in the field of health care.                       Results from the experiment validate Fredericks et al. study.  There is little evidence that cost neglect affects decision-making in health care. Finding that healthcare professionals are affected by the patient's identifiability but not the rest of the population. Finally, the study finds that the type of treatment, lifesaving or quality of life improving, has a significant influence on decision making, where life-determining treatments are prioritized to a lesser extent than life-quality improvement.

Place, publisher, year, edition, pages
2018. , p. 82
National Category
Economics
Identifiers
URN: urn:nbn:se:liu:diva-148346ISRN: LIU-IEI-FIL-A--18/02874--SEOAI: oai:DiVA.org:liu-148346DiVA, id: diva2:1215383
Subject / course
Master Thesis in Business Administration (Magisteruppsats från Ekonomprogrammet)
Available from: 2018-07-02 Created: 2018-06-08 Last updated: 2018-07-02Bibliographically approved

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