Patient and peer: Guideline design and expert response

Jane Greve*, Søren Rud Kristensen, Nis Lydiksen

*Kontaktforfatter

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstract

We examine how patients’ medical expertise influences adherence to clinical guidelines for a treatment that is common, costly, and rationed by the clinical guidelines. Using administrative data on prenatal diagnostic testing (PDT), we compare the testing rates of medically trained patients (experts) and non-medically trained patients (non-experts) on the margin of eligibility thresholds in clinical guidelines. We find that experts are 9 percentage points more likely to receive PDT than non-experts when they are not eligible for testing and that more than 80% of the difference can be attributed to medical expertise. Our results suggest that the design of clinical guidelines is important for adherence and that having medical expertise as a patient affects treatment, when there is room for a deviation from the guideline.

OriginalsprogEngelsk
Artikelnummer102806
TidsskriftJournal of Health Economics
Vol/bind92
Antal sider17
ISSN0167-6296
DOI
StatusUdgivet - dec. 2023

Bibliografisk note

Funding Information:
We thank the Danish Fetal Medicine Database for providing data, and we thank Mircea Trandafir, Giovanni Mellace, Thomas McGuire, Torben Tranæs, and seminar participants at the Health Economic Study Group 2021 workshop, at the European Health Economic Association seminar, at DaCHE–Danish Center for Health Economics seminar, seminar at Department of Economics, University of Southern Denmark, and at seminar at The Danish Center for Social Science Research for helpful comments and suggestions. We gratefully acknowledge financial support from the Novo Nordisk Foundation, Denmark (grant number NNF17OC0026466).

Funding Information:
We thank the Danish Fetal Medicine Database for providing data, and we thank Mircea Trandafir, Giovanni Mellace, Thomas McGuire, Torben Tranæs, and seminar participants at the Health Economic Study Group 2021 workshop, at the European Health Economic Association seminar, at DaCHE–Danish Center for Health Economics seminar, seminar at Department of Economics, University of Southern Denmark, and at seminar at The Danish Center for Social Science Research for helpful comments and suggestions. We gratefully acknowledge financial support from the Novo Nordisk Foundation, Denmark (grant number NNF17OC0026466 ).

Publisher Copyright:
© 2023 Elsevier B.V.

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