Scandinavian Working Papers in Economics

Working Paper Series,
Research Institute of Industrial Economics

No 1421: A Taste of Their Own Medicine: Guideline Adherence and Access to Expertise

Amy Finkelstein, Petra Persson (), Maria Polyakova and Jesse M. Shapiro
Additional contact information
Amy Finkelstein: MIT, Postal: and NBER
Petra Persson: Stanford University, Postal: and Research Institute of Industrial Economics (IFN), Stockholm, Sweden,
Maria Polyakova: Stanford University, Postal: and NBER
Jesse M. Shapiro: Brown University, Postal: and NBER

Abstract: We use population administrative data from Sweden to study adherence to 63 medication-related guidelines. We compare the adherence of patients without personal access to medical expertise to the adherence of those with access, namely doctors and their close relatives. We estimate that, among observably similar patients, access to expertise is associated with 3.8 percentage points lower adherence, relative to a baseline adherence rate of 54.4 percent among those without access. This association is larger for recommendations with a weaker clinical motivation. Our findings suggest an important role in non-adherence for factors other than those, such as ignorance, complexity, or failures of patient-provider communication, that would be expected to diminish with access to expertise.

Keywords: Information; Medical decision-making; Experts

JEL-codes: D83; I12; I18

Language: English

39 pages, December 13, 2021

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