When is choice a good thing?: An experimental study of the impact of choice on patient outcomes

The official published version can be obtained from the link below - Copyright @ Taylor & FrancisAlthough policy emphasises the benefits of choice, an increasing body of work points to times when choice may not always have positive consequences. The present experimental study aimed to explore the impact of choice on a number of patient outcomes in the health care setting. The study also explored the extent to which the influence of choice was affected by patient uncertainty and anticipated regret. Choice was conceptualized as consisting of two dimensions: ‘having choice’ which reflects the availability of a number of options and ‘making choice’ reflecting resolution and a desire for a choice to be made. Consecutive patients (n=427) from 4 General Practices in Surrey were asked to read one of 16 vignettes which varied in terms of 4 independent variables (having choice, making choice, uncertainty, anticipated regret) and to rate items relating to 4 outcome variables (patient satisfaction, perceived control, negative emotions, information seeking). The results showed that having more choice was consistently associated with more positive patient outcomes than having no choice. Having no choice was particularly detrimental for those experiencing anticipated regret and uncertainty. In contrast, whether or not a choice was made had no impact upon any of the outcome measures. In line with current policy having choice in the health care setting is related to improved patient outcomes. The results provide some insights into the factors which influence the direction of the impact of choice. They also indicate the importance of differentiating between ‘having choice’ and ‘making choice’.Funding received from ESRC award: RES-000-22-165

Executive Summary of Work Package 3 on Availability and Choice of Care of the ANCIEN Project. ENEPRI Research Report No. 101, February 2012

Work Package 3 on the Availability and Choice of Care of the ANCIEN project aims to document the forces driving the choice of formal and informal care across European countries and to characterise the linkages between the type of care used by dependent people and a country's institutional setting, which determines the supply of formal and informal care. Different issues related to formal and informal care choices and the LTC (long-term care) institutional setting in the EU have been analysed by the WP3 contributors. This research report summarises each partner’s contribution

Characterizing behavioral decisions with choice data

This paper provides an axiomatic characterization of choices in a setting where a decision-maker may not fully internalize all the consequences of her choices on herself. Such a departure from rationality, it turns out, is common across a variety of positive behavioral models and admits the standard rational choice model as a special case. We show that choice data satisfying (a) Senís axioms if and fully characterize behavioral decisions, and (b) Senís axiom if and if fully characterize standard decision-making. In addition, we show that (a) it is possible to identify a minimal and a maximal set of psychological states using choice data alone, and (b) under specific choice scenarios, "revealed mistakes" can be inferred directly from choice data

Strategic choice of price-setting algorithms

Recent experimental simulations have shown that autonomous pricing algorithms are able to learn collusive behavior and thus charge supra-competitive prices without being explicitly programmed to do so. These simulations assume, however, that both firms employ the identical price-setting algorithm based on Q-learning. Thus, the question arises whether the underlying assumption that both firms employ a Q-learning algorithm can be supported as an equilibrium in a game where firms can chose between different pricing rules. Our simulations show that when both firms use a learning algorithm, the outcome is not an equilibrium when alternative price setting rules are available. In fact, simpler price setting rules as for example meeting competition clauses yield higher payoffs compared to Q-learning algorithms

Raising Expectations: A State Scorecard on Long-Term Services and Supports for Older Adults, People With Physical Disabilities, and Family Caregivers

Ranks long-term services and supports systems for affordability and access, choice of setting and provider, quality of life and care, and family caregivers support. Explores contributing factors and roles of public policy and private-sector actions

Estimating monetary policy reaction functions : A discrete choice approach

I propose a discrete choice method for estimating monetary policy reaction functions based on research by Hu and Phillips (2004). This method distinguishes between determining the underlying desired rate which drives policy rate changes and actually implementing interest rate changes. The method is applied to ECB rate setting between 1999 and 2010 by estimating a forward-looking Taylor rule on a monthly basis using real-time data drawn from the Survey of Professional Forecasters. All parameters are estimated significantly and with the expected sign. Including the period of financial turmoil in the sample delivers a less aggressive policy rule as the ECB was constrained by the lower bound on nominal interest rates. The ECB's non-standard measures helped to circumvent that constraint on monetary policy, however. For the pre-turmoil sample, the discrete choice model's estimated desired policy rate is more aggressive and less gradual than least squares estimates of the same rule specification. This is explained by the fact that the discrete choice model takes account of the fact that central banks change interest rates by discrete amounts. An advantage of using discrete choice models is that probabilities are attached to the different outcomes of every interest rate setting meeting. These probabilities correlate fairly well with the probabilities derived from surveys among commercial bank economists.monetary policy reaction functions, discrete choice models, interest rate setting, ECB

The value of choice: A qualitative study

Background Providing choice in health care is part of an ongoing policy initiative Aim To explore how people understand choice in health care provision Setting South East England Design of Study A qualitative study using semi structured interviews Method Twenty two people recruited through advertising were interviewed about choice in general and choice in health care in particular. The data were analysed using template analysis. Results Participants grounded their consideration of choice in the NHS within the GP consultation. Four main themes about choice were identified: positive aspects of choice; the appearance of choice; unwanted choice; and the role of information in choice. In particular, there was strong assent to the value of choice in principle and having choice was seen as positive. The provision of choice options, however, was not always associated with the possibility of meaningful choice and participants felt that the appearance rather than the substance of choice was sometimes in evidence. Making – as opposed to having - choice was often unwanted and considered as indicative of erosion in trust in the GP and to occasion regret. Information was seen as a necessary but not sufficient prerequisite of informed choice Conclusion People value having choices rather than making choices but are concerned about choice provision for its own sake rather than choice that is available in a meaningful way. Health care policy that recommends an increase in choice per se may be met with scepticism which could ultimately undermine rather than promote the doctor / patient relationship