In the economics literature, clinical decision making has been modeled as a physician agency problem. In such a framework, economists assume that patients do not possess the information needed to make an optimal treatment choice, so they have to delegate the authority to physicians, who act as patients' perfect agent and make clinical decisions for the patients.
This dissertation re-examines the assumptions made in the traditional physician agency theory. It provides an economic analysis of how treatment choices are made when allowing different levels of information asymmetry between patients and physicians. I present a theoretical framework and an empirical estimation to demonstrate how different levels of information asymmetry and different levels of patient's awareness regarding their information affect patients' trust towards physicians and thereby affect the clinical decision making.
The dissertation consists of three essays. The title of Essay 1 is Clinical Decision Making and the Physician-Patient Relationship: Information Asymmetry in the Age of Patient Consumerism. It presents a conceptual model that allows non-uniformed information asymmetry between physician and patient. The title of Essay 2 is Physician-Patient Relationship and Consumer Satisfaction: The Impact of Information Search and Education. It empirically examines the hypotheses drawn from the theoretical model in Essay 1: how do patient's knowledge stock—education, and knowledge flow—the additional health information search, interact with each other and affect patient trust and satisfaction. The title of Essay 3 is Identifying the Physician Volume-Outcome Relationship: A New Approach. It empirically studies how knowledge flow affects health outcome from the physician side. I offer a new approach in identifying the physician volume-outcome relationship.
|School:||State University of New York at Stony Brook|
|School Location:||United States -- New York|
|Source:||DAI-A 69/01, Dissertation Abstracts International|
|Subjects:||Economics, Health care management|
|Keywords:||Awareness, Consumerism, Information asymmetry, Patient consumerism, Patient trust, Patient-physician relationship, Volume-outcome relationship|
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