School of Psychology, University of Plymouth, Plymouth, United Kingdom.
Health Psychol. 2011 Nov;30(6):719-27. doi: 10.1037/a0023951. Epub 2011 May 23.
The Medicare Modernization Act of 2003 (better known as Medicare Part D) represents the most important change to Medicare since its inception in the mid-1960s. The large number of drug plans being offered has raised concern over the complex design of the program. The purposes of this article are to examine the effect of age and choice set size (3 vs. 9 drug plans) on decision processes, strategy selection, and decision quality within the Medicare Part D program.
One hundred fifty individuals completed a MouselabWeb study, a computer-based program that allowed us to trace the information acquisition process, designed to simulate the official Medicare Web site.
The data reveal that participants identified the lowest cost plan only 46% of the time. As predicted, an increase in choice set size (3 vs. 9) was associated with 0.25 times the odds of correctly selecting the lowest cost plan, representing an average loss of $48.71. Older participants, likewise, tended to make poorer decisions.
The study provides some indication that decision strategy mediates the association between age and choice quality and provides further insight regarding how to better design a choice environment that will improve the performance of older consumers.
2003 年《医疗保险现代化法案》（更为人所知的是医疗保险 D 部分）是自 20 世纪 60 年代中期医疗保险推出以来最重要的一次改革。大量的药品计划的推出引起了人们对该计划复杂设计的关注。本文的目的是研究年龄和选择集大小（3 种与 9 种药品计划）对医疗保险 D 部分计划中的决策过程、策略选择和决策质量的影响。
150 名参与者完成了 MouselabWeb 研究，这是一个基于计算机的程序，允许我们追踪信息获取过程，旨在模拟官方医疗保险网站。
数据显示，只有 46%的参与者能够正确选择最低成本的计划。正如预测的那样，选择集大小的增加（3 种与 9 种）与正确选择最低成本计划的可能性增加了 0.25 倍，平均损失了 48.71 美元。同样，年龄较大的参与者往往做出较差的决策。
该研究表明，决策策略在年龄和选择质量之间的关联中起中介作用，并进一步深入了解如何更好地设计一个选择环境，以提高老年消费者的表现。
