Riise Julie, Hole Arne Risa, Gyrd-Hansen Dorte, Skåtun Diane
Department of Economics, University of Bergen, Postbox 7800, 5020 Beregen, Norway.
Department of Economics, The University of Sheffield, 9 Mappin Street, Sheffield S1 4DT, UK.
J Health Econ. 2016 Sep;49:169-83. doi: 10.1016/j.jhealeco.2016.07.001. Epub 2016 Jul 7.
We present results from an extensive discrete choice experiment, which was conducted in three countries (Norway, Scotland, and England) with the aim of disclosing stated prescription behaviour in different decision making contexts and across different cost containment cultures. We show that GPs in all countries respond to information about societal costs, benefits and effectiveness, and that they make trade-offs between them. The UK GPs have higher willingness to accept costs when they can prescribe medicines that are cheaper or more preferred by the patient, while Norwegian GPs tend to have higher willingness to accept costs for attributes regarding effectiveness or the doctors' experience. In general, there is a substantial amount of heterogeneity also within each country. We discuss the results from the DCE in the light of the GPs' two conflicting agency roles and what we know about the incentive structures and cultures in the different countries.
我们展示了一项广泛的离散选择实验的结果，该实验在三个国家（挪威、苏格兰和英格兰）进行，目的是揭示在不同决策背景和不同成本控制文化下的既定处方行为。我们表明，所有国家的全科医生都会对有关社会成本、效益和有效性的信息做出反应，并且他们会在这些因素之间进行权衡。英国的全科医生在能够开更便宜或患者更偏好的药物时，接受成本的意愿更高，而挪威的全科医生在涉及有效性或医生经验等属性方面接受成本的意愿往往更高。总体而言，每个国家内部也存在大量的异质性。我们根据全科医生的两种相互冲突的代理角色以及我们对不同国家激励结构和文化的了解来讨论离散选择实验的结果。
