When Should You Trust Your Doctor? – Healthcare Economist

by akoloy

That is the title of a current examine I printed with Michael Halasy in Mayo Clinic Proceedings. The subtitle is Establishing a Theoretical Model to Evaluate the Value of Second Opinion Visits. The summary is beneath:

In order to provide a mathematical mannequin for higher understanding of the advantages and utilization of second opinions and to grasp the contradiction between the worth of second opinions and their perceived underuse, we developed an anticipated utility idea mannequin to quantify their worth. We use a case-based instance to seek out forms of biases that would have an effect on second opinions. Although the baseline anticipated utility idea mannequin introduced assumes suppliers are rational, we loosen up this and focus on the implications for the way these various specs alter predicted use. We discovered that second opinions are worthwhile when diagnostic accuracy is variable throughout physicians or entry to high-quality care is restricted. In a stylized simulation instance by which about half (50.1%) of diagnoses had been incorrect, receipt of 1 second opinion lowered the error fee to 25.8% and receipt of two second opinions lowered the error fee to 16.0%. After incorporating potential biases into the mannequin, the worth of second opinions will increase solely when aversion to altering the preliminary prognosis is larger than aversion to correcting a mistake. Additionally, this mannequin reveals that second opinions have worth even when diagnostic accuracy is ideal. Further, when monetary incentives differ from the incentives of the preliminary seek the advice of, a second opinion gives sufferers an affordable certain of their remedy choices. To conclude, we determine quite a few causes for underuse of second opinions. Specifically, worth is determined by the diploma of diagnostic uncertainty, presence of behavioral biases, and variation in native compensation regimes. Despite their worth, current traits may truly lower the worth of second opinions.

Do learn the entire article here.

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