An empirical investigation of patient preferences and the use of information when choosing medical treatment technologies

该项目旨在研究患者偏好和信息在患者选择医疗技术时的作用。健康经济学家和政界人士对患者行为的这些方面非常感兴趣，因为最近的医疗改革，例如德国和美国的改革，将决定权下放给了患者。关于患者行为的可靠数据对于模拟医疗市场激励的效果和设计最优的政策干预都是至关重要的。我想利用实验调查技术和美国人口的随机样本，分析患者如何在与医生的互动中选择医疗技术。医生既是专家，又是医疗服务的提供者。因此，医生的建议可能不仅基于患者的效用，而且还基于他们自己的经济激励。考虑到医生潜在的利益冲突，重要的是调查政府和保险公司的替代信息来源如何影响患者的选择。该项目的具体目标是(I)开发和实施一种创新的调查工具，以衡量患者的偏好并研究替代信息来源的重要性，(Ii)在具有代表性的样本中管理调查，以及(Iii)使用用于离散选择的计量经济学模型来分析数据。我可以与圣塔莫尼卡兰德大学的Arie Kapteyn教授合作，从2012年1月到4月准备和实施这项调查。选择兰德作为主办机构的一个重要原因是，除了其出色的研究基础设施外，还可以作为美国国立卫生研究院(NIH)资助的长期项目的一部分进行调查。该调查工具将在美国生活小组(ALP)中实施，这是一个由兰德主持的创新互联网小组。我们已成功地进行了一项初步研究。

This project aims at examining the role of patient preferences and the use of information when patients choose medical treatment technologies. These aspects of patient behavior are of great interest for health economists and politicians alike because recent health care reforms, for example in Germany and the U.S., delegate decisions to patients. Reliable data on patient behavior is crucial both to modeling the effects of incentives in health care markets and to designing optimal policy interventions.Using experimental survey techniques and a random sample of the U.S. population, I would like to analyze how patients choose medical technologies in interaction with their physicians. Physicians act both as experts and suppliers of medical services. Thus, a physicians advice might be based not only on the patients utility but also on their own financial incentives. Given the physicians potential conflict of interest, it is important to investigate how alternative sources of information the government, insurers impact patients choices. The specific aims of the project are (i) to develop and implement an innovative survey instrument to measure patients preferences and to study the importance of alternative sources of information, (ii) to administer the survey in a representative sample, and (iii) to analyze the data using econometric models for discrete choice. I can prepare and implement the survey from January to April 2012 in collaboration with Prof. Arie Kapteyn at RAND, Santa Monica. An important reason to choose RAND as a host institution besides its excellent research infrastructure is the possibility to conduct the survey as part of a long-term project financed by the U.S. National Institutes of Health (NIH). The survey instrument will be implemented in the American Life Panel (ALP), an innovative internet panel that is hosted by RAND. A pilot study has already been successfully conducted.