Madsen Kristoffer Panduro, Kjær Trine
Health Promotion Research, Copenhagen University Hospital - Steno Diabetes Center, Copenhagen, Herlev, Denmark.
Danish Centre for Health Economics, University of Southern Denmark, Odense, Denmark.
Health Econ. 2024 Sep;33(9):1949-1961. doi: 10.1002/hec.4857. Epub 2024 May 27.
Identifying determinants of heterogeneity in health outcomes continues to be a focus in the health economic literature. In this study, we analyze whether time preferences predict health outcomes in individuals with type 1 diabetes (T1D) who use insulin pump therapy to manage their condition. We collect data on time preferences using a hypothetical matching task and estimate aggregate as well as individual-level discounting parameters using the exponential, hyperbolic, and quasi-hyperbolic discounting models. These parameters are then regressed against essential diabetes-related health outcomes obtained from registries and medical records, including glycemic control, kidney function, BMI, and number of hospital contacts. Our analyses indicate that all three discounting models fit the data equally well. Except for hospital contacts, we find robust evidence that impatience, as reflected by higher discounting, predicts worse health outcomes. Additionally, present bias is associated with worse kidney function. Our findings suggest that time preferences can explain some of the heterogeneity in health among individuals with T1D and call for increased attention on the role of time preferences in the design of disease management programs for individuals with chronic conditions.
确定健康结果异质性的决定因素仍然是健康经济学文献的一个重点。在本研究中,我们分析了时间偏好是否能预测使用胰岛素泵疗法控制病情的1型糖尿病(T1D)患者的健康结果。我们使用一个假设匹配任务收集时间偏好数据,并使用指数、双曲线和准双曲线贴现模型估计总体以及个体层面的贴现参数。然后,将这些参数与从登记处和医疗记录中获得的基本糖尿病相关健康结果进行回归分析,这些结果包括血糖控制、肾功能、体重指数和住院次数。我们的分析表明,所有三种贴现模型对数据的拟合效果相同。除了住院次数外,我们发现有力证据表明,较高贴现率所反映的不耐烦预示着更差的健康结果。此外,现时偏向与更差的肾功能有关。我们的研究结果表明,时间偏好可以解释T1D患者健康状况的一些异质性,并呼吁在为慢性病患者设计疾病管理项目时,更多地关注时间偏好的作用。