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GPs’ implicit prioritization through clinical choices – evidence from three national health services

机译:全科医生通过临床选择隐含优先次序 - 来自三个国家卫生服务机构的证据

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摘要

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.
机译:我们介绍了在三个国家(挪威,苏格兰和英国)进行的广泛离散选择实验的结果,目的是揭示在不同决策环境和不同成本控制文化中规定的处方行为。我们表明,所有国家/地区的GP都会回应有关社会成本,收益和有效性的信息,并在它们之间进行权衡。英国全科医生可以开出更便宜或更受患者青睐的药物时,他们愿意接受费用的意愿更高,而挪威全科医生则倾向于出于有效性或医生经验的属性而愿意接受费用。通常,每个国家内部也存在大量异质性。我们将根据GP的两个相互冲突的代理机构角色以及我们对不同国家/地区的激励结构和文化的了解来讨论DCE的结果。

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