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The effect of decision fatigue on surgeons clinical decision making
Linköping University, Department of Management and Engineering, Economics. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Management and Engineering, Economics. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
Linköping University, Department of Management and Engineering, Economics. Linköping University, Faculty of Arts and Sciences.ORCID iD: 0000-0002-8159-1249
2019 (English)In: Health Economics, ISSN 1057-9230, E-ISSN 1099-1050Article in journal (Refereed) Epub ahead of print
Abstract [en]

The depleting effect of repeated decision making is often referred to as decision fatigue. Understanding how decision fatigue affects medical decision making is important for achieving both efficiency and fairness in health care. In this study, we investigate the potential role of decision fatigue in orthopedic surgeons decisions to operate, exploiting a natural experiment whereby patient allocation to time slots is plausibly randomized at the level of the patient. Our results show that patients who met a surgeon toward the end of his or her work shift were 33 percentage points less likely to be scheduled for an operation compared with those who were seen first. In a logistic regression with doctor-fixed effects and standard errors clustered at the level of the doctor, the odds of operation were estimated to decrease by 10.5% (odds ratio=0.895, pamp;lt;.001; 95% CI [0.842, 0.951]) for each additional patient appointment in the doctors work shift. This pattern in surgeons decision making is consistent with decision fatigue. Because long shifts are common in medicine, the effect of decision fatigue could be substantial and may have important implications for patient outcomes.

Place, publisher, year, edition, pages
WILEY , 2019.
Keywords [en]
decision fatigue; ego depletion; medical decision making; time of day
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-159888DOI: 10.1002/hec.3933ISI: 000479690400001PubMedID: 31344303OAI: oai:DiVA.org:liu-159888DiVA, id: diva2:1346144
Note

Funding Agencies|Ostergotland County Council (ALF project); Ragnar Soderberg foundation; Marianne and Marcus Wallenberg foundation [MMW2014.0187]

Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2019-11-20

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Persson, EmilBarrafrem, KingaMeunier, AndreasTinghög, Gustav
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EconomicsFaculty of Arts and SciencesDivision of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Orthopaedics in Linköping
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Health Economics
Health Care Service and Management, Health Policy and Services and Health Economy

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