A practitioner's guide to nudging

Supporting documentatio

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Consumers' waiting in queues: The role of first-order and second-order justice

Past research on queuing has identified social justice as an important determinant of consumers' waiting experiences. In queuing settings, people's perception of social justice is affected by whether the principle of first in and first out (FIFO) has been violated. However, even when service follows the FIFO principle, waiting time may still differ from one consumer to another for various reasons. For instance, a consumer who happens to arrive in the queue after a large group of people may have to wait longer than average. In this research, it is argued that, aside from and independent of the FIFO principle, consumers also care about whether everyone spends an approximately equal amount of time waiting before availing of the product or service. When consumers perceive that they have spent more time waiting than others and when they can attribute this injustice to the service provider, they will be less satisfied with the waiting experience. It is also proposed that adherence to the FIFO principle is a more salient concern to consumers (thus termed "first-order" justice), and equal waiting time (''second-order'' justice) matters only when first-order justice is not an issue. Three studies support the predictions. (C) 2008 Wiley Periodicals, Inc

The effect of intermediate rewards on the effectiveness of incentive programs

NUS Business School Research Paper Series; 2010-0061-2