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首页> 外文期刊>Social science and medicine >When you can't have the cake and eat it too. A study of medical doctors' priorities in complex choice situations
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When you can't have the cake and eat it too. A study of medical doctors' priorities in complex choice situations

机译：当你不能吃蛋糕也不能吃的时候。复杂选择情况下医生的优先事项研究

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Available literature provides little insight into medical doctors' prescription choices when they are required to make complex trade-offs between different concerns such as treatment effect, costs, and patient preferences simultaneously. This study investigates this issue. It is based on a Discrete Choice Experiment (DCE) conducted with 571 Norwegian doctors, where the DCE captures preferences for medications described along five dimensions important for both clinical decision-making and prioritisation in the health sector. Although effectiveness is the most important determinant of choice in our study, doctors also put considerable weight on patients' preferences and on avoiding high total costs. The probability of choosing a particular medication increases when doctors have a positive experience with the medication. GPs value high clinical effectiveness less than hospital consultants do. They are also less concerned with patient preferences. For both groups of doctors it turns out that they are willing to make difficult trade-offs between attributes they are often assumed not to be willing to compromise on, like effectiveness or patient preferences, and cost measures - given that they have proper information about these attributes.
机译：当需要医生在不同方面（例如治疗效果，成本和患者喜好）之间进行复杂的权衡时，可用的文献无法深入了解医生的处方选择。这项研究调查了这个问题。它基于与571名挪威医生进行的离散选择实验（DCE），其中DCE捕获了从五个方面描述的药物偏爱，这五个方面对临床决策和卫生部门的优先次序都很重要。尽管有效性是我们研究中选择的最重要决定因素，但医生也非常重视患者的喜好并避免高昂的总费用。当医生对药物有积极的经验时，选择特定药物的可能性会增加。全科医生对临床有效性的重视程度不及医院顾问。他们也较少关注患者的喜好。事实证明，对于这两组医生，他们都愿意在他们通常不愿意妥协的属性之间进行艰难的折衷，例如有效性或患者喜好以及费用衡量标准，因为他们拥有适当的信息属性。

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