Incentives and Gender in a Multi-task Setting: an Experimental Study with Real-Effort Tasks

This paper investigates the behavioural effects of competitive, social-value and social-image incentives on men’s and women’s allocation of effort in a multi-task environment. Specifically, using two real-effort laboratory tasks, we investigate how competitive prizes, social-value generation and public awards affect effort allocation decisions between the tasks. We find that all three types of incentives significantly focus effort allocation towards the task they are applied in, but the effect varies significantly between men and women. The highest effort distortion lies with competitive incentives, which is due to the effort allocation decision of men. Women exert similar amount of effort across the three incentive conditions, with slightly lower effort levels in the social-image incentivized tasks. Our results inform how and why genders differences may persist in competitive workplaces

The doctor-patient relationship: A review of the theory and policy implications

The LSE companion to health policy covers a wide range of conceptual and practical issues from a number of different perspectives introducing the reader to, and summarising, the vast literature that analyses the complexities of health policy. The companion also assesses the current state of the art

Specialist nurses' perceptions of inviting patients to participate in clinical research studies: a qualitative descriptive study of barriers and facilitators

BACKGROUND: Increasing the number of patients participating in research studies is a current priority in the National Health Service (NHS) in the United Kingdom. The role of specialist nurses in inviting patients to participate is important, yet little is known about their experiences of doing so. The aim of this study was to explore the perceptions of barriers and facilitators held by specialist nurses with experience of inviting adult NHS patients to a wide variety of research studies. METHODS: A cross-sectional qualitative descriptive study was conducted between March and July 2015. Participants were 12 specialist nurses representing 7 different clinical specialties and 7 different NHS Trusts. We collected data using individual semi-structured interviews, and analysed transcripts using the Framework method to inductively gain a descriptive overview of barriers and facilitators. RESULTS: Barriers and facilitators were complex and interdependent. Perceptions varied among individuals, however barriers and facilitators centred on five main themes: i) assessing patient suitability, ii) teamwork, iii) valuing research, iv) the invitation process and v) understanding the study. Facilitators to inviting patients to participate in research often stemmed from specialist nurses' attitudes, skills and experience. Positive research cultures, effective teamwork and strong relationships between research and clinical teams at the local clinical team level were similarly important. Barriers were reported when specialist nurses felt they were providing patients with insufficient information during the invitation process, and when specialist nurses felt they did not understand studies to their satisfaction. CONCLUSION: Our study offers several new insights regarding the role of specialist nurses in recruiting patients for research. It shows that strong local research culture and teamwork overcome some wider organisational and workload barriers reported in previous studies. In addition, and in contrast to common practice, our findings suggest research teams may benefit from individualising study training and invitation procedures to specialist nurses' preferences and requirements. Findings provide a basis for reflection on practice for specialist nurses, research teams, policymakers, and all with an interest in increasing patient participation in research

Retirement and Household Expenditure in Turbulent Times

We examine the impact of own and spousal retirement on household expenditure during a period of financial deterioration. We use detailed household data covering the period 2009-2016 in Greece, during which the country experienced a severe financial crisis that affected retirees in ways that were not anticipated. Similar to Moreau and Stancanelli (2015) our empirical strategy allows for the household expenditure to depend on both own and spousal retirement status. We employ an instrumental variable identification strategy by exploiting variation coming from the early retirement age threshold. Our Two-Stage Least Squares estimates show that, even after controlling for income, total expenditure drops significantly when the husband retires and as he becomes older. The reduction is stronger in 2010, when the first wave of austerity plans, including measures affecting pensioners were announced, and after 2014 when horizontal pension cuts were implemented. Expenditure does not change significantly when the wife retires neither the older she gets. A drop-in expenditure for clothing, transport, housing and communication drives the overall reduction in expenditure. Overall, our results can have significant policy implications in the design of structural pension reforms in a period of financial hardship

Most UK scientists who publish extremely highly-cited papers do not secure funding from major public and charity funders: A descriptive analysis

The UK is one of the largest funders of health research in the world, but little is known about how health funding is spent. Our study explores whether major UK public and charitable health research funders support the research of UK-based scientists producing the most highly-cited research. To address this question, we searched for UK-based authors of peer-reviewed papers that were published between January 2006 and February 2018 and received over 1000 citations in Scopus. We explored whether these authors have held a grant from the National Institute for Health Research (NIHR), the Medical Research Council (MRC) and the Wellcome Trust and compared the results with UK-based researchers who serve currently on the boards of these bodies. From the 1,370 papers relevant to medical, biomedical, life and health sciences with more than 1000 citations in the period examined, we identified 223 individuals from a UK institution at the time of publication who were either first/last or single authors. Of those, 164 are still in UK academic institutions, while 59 are not currently in UK academia (have left the country, are retired, or work in other sectors). Of the 164 individuals, only 59 (36%; 95% CI: 29-43%) currently hold an active grant from one of the three funders. Only 79 (48%; 95% CI: 41-56%) have held an active grant from any of the three funders between 2006-2017. Conversely, 457 of the 664 board members of MRC, Wellcome Trust, and NIHR (69%; 95% CI: 65-72%) have held an active grant in the same period by any of these funders. Only 7 out of 655 board members (1.1%) were first, last or single authors of an extremely highly-cited paper. There are many reasons why the majority of the most influential UK authors do not hold a grant from the country’s major public and charitable funding bodies. Nevertheless, the results are worrisome and subscribe to similar patterns shown in the US. We discuss possible implications and suggest ways forward

Crises and mortality: Does the level of unemployment matter?

The relationship between mortality and economic fluctuations has been a topic of long interest, which intensified following the 2008 global financial crisis. We study whether mortality responds non-linearly and asymmetrically to unemployment in the context of national economic crises. Although these assumptions have been challenged in other domains, they have been neglected in the mortality literature. Greece offers an ideal setting as unemployment was decreasing until mid-2008, but then it was sharply increased as a result of a severe economic crisis. We use quarterly data on regional unemployment and mortality from 1999 to 2013, giving a balanced panel of 780 observations. We find evidence of a countercyclical total mortality, especially for the older groups, and a further deteriorating crisis effect. We provide evidence that the relationship is non-linear and asymmetric, suggesting that the effect on death rates changes for very high values of unemployment and depends on its direction. Both non-linearity and asymmetry are mainly driven by those above 65 years old. The results suggest that the mechanisms explaining these effects are likely to vary across age groups. Our findings have important methodological implications and suggest that empirical investigations on fluctuations, recessions and mortality should not ignore possible non-linear and asymmetric behaviours, especially during turbulent times

Patients’ willingness to complete written incident report forms in one UK tertiary cancer hospital

This article examines patients’ willingness to complete incident report forms (IRF), providing a description of the event or concern. Differing from other studies, its design enabled patients to report incidents when and if they felt this necessary, rather than responding to researchers’ questions. 145 patients receiving treatment for cancer in a UK hospital were invited to participate. Of the 100 patients who agreed to participate, only 13 completed a total of 22 forms. The form’s purpose was not easily understood, often perceived as complaining and patients tended to report relatively trivial matters. Contrary to previous studies, this study found little evidence that IRFs are the right tool for enabling patients’ proactive involvement in safety improvement. Asking patients to monitor their safety by completing IRFs may serve to undermine patients’ trust in their clinicians while duplicating resources

Bundling in General Markets and in Health Care Systems

This paper provides an overview of bundling, by explaining, in general, the different forms that this practice can take in selling, buying or exchanging goods. We then proceed with a linear programming formulation in health care, to explain how the price of a bundle of resources can be calculated. We follow this by looking at the specific case of the practice of bundling by Medicare, the social insurance system for health care in the United States. We consider its advantages, disadvantages, and various recommendations

Enhancing clinical communication in dermatologists: a personalized educational intervention

OBJECTIVES: Effective communication is a vital component of patient-centered consultations with favorable treatment outcomes. This study aimed in testing the effectiveness of a personalized, communication training program for dermatologists in their practices. METHODS: Fifteen dermatologists were offered the educational intervention NO.TE.S. (Non-Technical Skills). Depending on the dermatologists' needs, seven to nine sessions with a 60-min duration were performed, focusing on: patient-centered care, principles of Neurolinguistic Programming, a guide to the medical interview, principles of motivational interviewing and self-care. After the program's completion, participants completed anonymously an 18-item evaluation questionnaire. RESULTS: All 14 participants would suggest NO.TE.S to a colleague. According to the main themes identified, their participation led to (i) re-consideration of the physician-patient relationship, (ii) more conscious application of the patient-centered model, (iii) improvement in communication skills, (iv) awareness of medical interview guides, (v) increase in self-confidence, and (vi) techniques of self-care. Eleven physicians (78.6%) declared improvement in patients' satisfaction, 14 (100%) in their own satisfaction, seven (50%) in adherence to therapeutic plan and seven (50%) in treatment outcomes. CONCLUSION: The one-to-one coaching is a convenient and well-received personalized means of enhancing clinical communication in dermatologists, leading to more patient-centered medical encounters with better treatment outcomes