Artois University, UMR 9221, Lille Economie Management (LEM), UFR EGASS, 9 Rue du Temple, BP 10665, 62030, Arras Cedex, France.
ALISS UR1303, INRA, Université Paris-Saclay, F-94205, Ivry-Sur-Seine, France.
Eur J Health Econ. 2018 Jul;19(6):843-860. doi: 10.1007/s10198-017-0925-3. Epub 2017 Aug 31.
This paper investigates the predictive power of several risk attitude measures on a series of medical practices. We elicit risk preferences on a sample of 1500 French general practitioners (GPs) using two different classes of tools: scales, which measure GPs' own perception of their willingness to take risks between 0 and 10; and lotteries, which require GPs to choose between a safe and a risky option in a series of hypothetical situations. In addition to a daily life risk scale that measures a general risk attitude, risk taking is measured in different domains for each tool: financial matters, GPs' own health, and patients' health. We take advantage of the rare opportunity to combine these multiple risk attitude measures with a series of self-reported or administratively recorded medical practices. We successively test the predictive power of our seven risk attitude measures on eleven medical practices affecting the GPs' own health or their patients' health. We find that domain-specific measures are far better predictors than the general risk attitude measure. Neither of the two classes of tools (scales or lotteries) seems to perform indisputably better than the other, except when we concentrate on the only non-declarative practice (prescription of biological tests), for which the classic money-lottery test works well. From a public health perspective, appropriate measures of willingness to take risks may be used to make a quick, but efficient, profiling of GPs and target them with personalized communications, or interventions, aimed at improving practices.
本文探讨了几种风险态度衡量标准对一系列医疗实践的预测能力。我们通过两种不同类型的工具在 1500 名法国全科医生(GP)样本中得出风险偏好:量表,衡量 GP 自身对风险的承受意愿在 0 到 10 之间的感知;和彩票,要求 GP 在一系列假设情况下在安全和风险选项之间进行选择。除了衡量一般风险态度的日常生活风险量表外,每种工具还在不同领域衡量风险承担:财务事项、GP 自身健康和患者健康。我们利用难得的机会将这些多种风险态度衡量标准与一系列自我报告或行政记录的医疗实践相结合。我们先后测试了我们的七种风险态度衡量标准对十一种影响 GP 自身健康或患者健康的医疗实践的预测能力。我们发现,特定领域的衡量标准远比一般风险态度衡量标准更具预测能力。两种工具类别(量表或彩票)都没有明显优于另一种,除了我们集中在唯一的非声明实践(生物测试的处方)上,对于这种实践,经典的货币彩票测试效果很好。从公共卫生的角度来看,适当的风险承受意愿衡量标准可用于快速但有效地对 GP 进行分析,并针对他们进行个性化的沟通或干预,以改善实践。