LDI Issue Brief. 2011 Sep;17(1):1-8.
The application of behavioral economics to health and health care has captured the imagination of policymakers across the political spectrum. The idea is that many people are irrational in predictable ways, and that this both contributes to unhealthy behaviors like smoking and holds one of the keys to changing those behaviors. Because health care costs continue to increase, and a substantial portion of costs are incurred because of unhealthy behaviors, employers and insurers have great interest in using financial incentives to change behaviors. However, it is in the details that complexity and controversies emerge. Who should the targets be, and what outcomes should be rewarded? How should incentives be structured, to maximize their effectiveness and minimize unintended consequences? In what situations should we be intervening to affect decisions by people who may prefer to be obese or to smoke, and in what situations should we accept their preferences? To begin to answer these questions, the Penn-CMU Roybal P30 Center on Behavioral Economics and Health held its first annual Behavioral Economics and Health Symposium on March 24-25, 2011 with support from the Robert Wood Johnson Foundation. The symposium drew more than 50 researchers, scholars, and health professionals from a variety of disciplines, including medicine, public health, economics, law, management, marketing, and psychology. They heard perspectives on behavioral economics from public and private funders, the CEO of the University of Pennsylvania Health System, and the CEO of stickK.com, a start-up company that uses online, voluntary commitment contracts to help people achieve their goals. Participants formed eight working groups to review the current state-of-the-art in a variety of clinical contexts and to consider how behavioral economics could inform a research agenda to improve health. This Issue Brief summarizes the findings of these working groups and the symposium.
行为经济学在健康及医疗保健领域的应用引发了各界政策制定者的关注。其理念是,许多人在可预测的方面表现出非理性,这既导致了吸烟等不健康行为,也是改变这些行为的关键之一。由于医疗保健成本持续上升,且很大一部分成本是由不健康行为造成的,雇主和保险公司对利用经济激励措施来改变行为有着浓厚兴趣。然而,正是在细节方面出现了复杂性和争议。目标人群应该是谁,应该奖励哪些结果?激励措施应如何构建,以最大限度地提高其有效性并尽量减少意外后果?在哪些情况下我们应该进行干预,以影响那些可能倾向于肥胖或吸烟的人的决策,而在哪些情况下我们应该接受他们的偏好?为了开始回答这些问题,宾夕法尼亚大学 - 卡内基梅隆大学罗伊巴尔行为经济学与健康P30中心在罗伯特·伍德·约翰逊基金会的支持下,于2011年3月24日至25日举办了首届年度行为经济学与健康研讨会。该研讨会吸引了来自医学、公共卫生、经济学、法律、管理、营销和心理学等多个学科的50多名研究人员、学者和健康专业人士。他们听取了来自公共和私人资助者、宾夕法尼亚大学医疗系统首席执行官以及stickK.com公司首席执行官关于行为经济学的观点,stickK.com是一家初创公司,利用在线自愿承诺合同帮助人们实现目标。与会者组成了八个工作组,以审查各种临床背景下的当前技术水平,并考虑行为经济学如何为改善健康的研究议程提供信息。本问题简报总结了这些工作组和研讨会的成果。