Preferences and Experiments

Einleitung / Introduction

The functional burden of vertigo, dizziness, and balance disorders (VDB) might depend on the personality traits of the patients affected. The aim of this study thus was to investigate the impact of self-efficacy, risk attitudes, and time preferences on vertigo-specific functioning in older patients with VDB before and after treatment in a specialized tertiary care center.

Methode / Method

Data for this study was obtained from the MobilE-TRA2 cohort study, conducted at a specialized tertiary care center in Germany. Patients aged 60 and older were assessed during their initial stay at the care center and three months later, using self-administered questionnaires. Self-efficacy was measured on a scale from 1 (very low) to 5 (very high). Health-related risk attitudes were inquired using an 11-point scale. Time preferences were measured by evaluating patients' willingness to postpone a reward in favor of a greater benefit on an 11-point Likert scale. Vertigo-specific functioning was evaluated using the Dizziness Handicap Inventory, representing functional, emotional, and physical aspects of functional disability caused by VDB. Mixed-effects regression models were used to analyze the association between the selected personality traits and vertigo-specific functioning over time. Interaction terms with time were incorporated for each personality trait, enabling the assessment of their influence on functioning three months following the initial observation period.

Ergebnisse / Results

An overall of 337 patients (53% women, median age at baseline = 70 years) were included. Patients with higher self-efficacy (Beta = -3.82, 95%-CI [-6.56; -1.08]) and higher willingness to take risks (Beta = -1.31, 95%-CI [-2.31; -0.31]) reported better functioning during their initial visit at the care center. Self-efficacy significantly predicted functioning after three months for overall functioning (Beta = -4.21, 95%-CI [-6.57; -1.84]) and all three domains.

Zusammenfassung / Conclusion

Our findings suggest that patients with high self-efficacy and high willingness to take risks may exhibit better coping mechanisms when faced with the challenges of VDB. Promoting self-efficacy may help patients to better manage the duties accompanying their treatment, leading to improved functioning. These insights may inform the development of personalized treatment aimed at reducing the functional burden of VDB in older patients.

AutorInnen

Benedict Katzenberger, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), LMU Munich

Sebastian Fuchs, Department of Orthopaedics and Trauma Surgery, LMU Munich

Lars Schwettmann, Department of Health Services Research, Carl von Ossietzky University Oldenburg

Ralf Strobl, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), LMU Munich

Ari Hauser, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), LMU Munich

Daniela Koller, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), LMU Munich

Eva Grill, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), LMU Munich

Einleitung / Introduction

According to standard economic theory, individuals are assumed to be rational actors. They respond predictably to changes in prices through substitution when confronted with homogeneous goods in a competitive market without friction. As such they optimize their utility in a straightforward manner. However, empirical observations often reveal a contrast between these theoretical assumptions and actual human behavior. As such, consumer choices gain more importance in public policy and when implementing new policies. Consumer choices of future policy incentives are drawn from stated preferences which can be prone to hypothetical bias, meaning an actual choice that does not correspond to the stated preference. This phenomenon is called Intention Behavior Gap. I exploit a price framing reform in the German health insurance market in 2009. It changed from health insurance specific payroll tax differences to a standardized payroll tax contribution. Additional fees had to be expressed explicitly and were charged mostly in absolute euro values. Enrollees of insurance funds charging additional fees were informed and had the chance to easily switch funds. This setting enables me to study the general extent of Intention Behavior Gap in a real-world setting of a competitive market with little friction. Further, I explore common psychological and socioeconomic traits of individuals showing Intention Behavior Gap in this setting.

Methode / Method

I study stated and revealed consumer choices in responds to the German sickness funds price framing reform in 2009. The empirical analysis relies on rich individual-level panel data from the German Socio-Economic Panel Study (SOEP). The SOEP questionnaire includes a stated preference question on enrollees willingness to switch health insurance in responds to additional fees that was asked before the reform and a question on their revealed preferences asked after the reform. Further, the SOEP includes socioeconomic and psychological traits. I present descriptive statistics on the phenomenon of Intention Behavior Gap in the health insurance market. To explore the common psychological and socioeconomic traits of individuals showing Intention Behavior Gap, I use probit estimations.

Ergebnisse / Results

I find that stated preferences have predictive power for actual behavior in this setting. Still, overall, one third of enrollees show Intention Behavior Gap. Especially negative and positive reciprocal people have a higher probability to show Intention Behavior Gap.

Zusammenfassung / Conclusion

Knowledge about common psychological or socioeconomic traits of people showing Intention Behavior Gap in competitive markets can be useful as controls for further stated preference analysis.

AutorInnen

Anna Werbeck, RWI Essen

Einleitung / Introduction

Private health insurance (PHI) is a relevant financing source in many health care systems, including the Austrian one where more than a third of the population possess such an insurance. The effect of PHI on redistribution preferences in health care has been an understudied phenomenon. This article examines such a relationship. Further the mediating effect of fairness attitudes within said relationship is analysed.

Methode / Method

The data for this study come from two waves of the Austrian Corona Panel Project (ACPP) 2021 and 2022 . To initially assess each redistribution preference separately I apply fixed-effects graded response modelling (GRM) with cluster-robust covariance estimators. In a next step a cluster-robust conditional mixed process (CMP) estimator that relies on eight ordered pooled Probit regression equations - one for each preference item - is fitted. Further analysis with the preference-index is conducted, using cluster-robust random-effects generalised least squares (RE-GLS) regression models. Control variables are examined independently and then inserted into the initial model. Subsequently, an interaction model is computed to elucidate the interaction between the two main predictors and income in their effect on redistribution preferences. To further assess robustness of my primary analyses, I conduct a treatment-effects estimation for a linear outcome (ML) with augmented inverse-probability weighting (AIPW) estimation, a logit treatment model, and cluster-robust SEs. This estimation evaluates the average treatment effect and the potential-outcome means from observational data. I employ presence versus absence of PHI-coverage as estimated treatment levels.

Ergebnisse / Results

In this article evidence for considerable self-interest in support for redistribution in health care with matching fairness attitudes is found. Additionally, political party preferences and pandemic risk perception play a role.

Zusammenfassung / Conclusion

Health policy makers should carefully consider these relationships when adapting the public health care system to challenges, such as increased financing pressure or a pandemic. This could be done by incorporating vulnerable groups and public preferences at large in an open debate about the design of the health care system, its financing and its consequences for redistribution.

AutorInnen

Thomas Resch

Einleitung / Introduction

The rapid and far-reaching dissemination of misinformation on social media is a threat to global health. As a consequence, several media platforms have established tools to combat its spread like fact-checks or warning signs. In this research project, we assess the effectiveness of two tools (pre- and debunking) on sharing behavior of accurate and misleading news in the context of vaccination in Sub-Saharan Africa and examine the underlying psychological mechanisms. A novelty of our study is the introduction of endogenous information acquisition that allows us to shed light on the impact of confirmatory search behavior. We address the following research questions: (1) How is vaccine-related news selected on social media selected? (2) Is non-selected news processed differently than self-selected news? (3) What is the effect of the forewarning and the fact-check on sharing of vaccine news, both accurate information and misinformation? (4) Does the effectiveness of these tools differ depending on the article choice of readers?

Methode / Method

We conducted an online survey experiment among 11,192 Facebook users in six Sub-Saharan African countries. Participants selected one news article based on two headlines, one of which supporting a vaccine, while the other claimed infertility as a possible side effect. Afterwards, they were randomly presented one of the two article versions.Participants were the randomly assigned into (1) control, (2) pre- (warning sign) or (3) debunking (fact-check) group. Afterwards, participants stated their intention to share and were given the opportunity to do so on Facebook, our main outcome of interest. By comparing sharing behaviour between the intervention groups, we can assess the effectiveness of the anti-fake-news tools. Moreover, we estimate heterogeneous effects by article preference to assess the influence of endogenous information acquisition.

Ergebnisse / Results

Our results show that individuals select news that are personally relevant, conform with their prior beliefs, and allow them to maintain optimistic expectations. 41,4% showed a preference for the infertility article. With respect to sharing behaviour, in our experiment, 15.4 % shared content on Facebook. Both interventions, the warning sign as well as the fact-check have been effective in reducing the sharing of misinformation. In our main specification, we estimate that the fact-check reduced sharing of misinformation by 18% and the warning sign by 15%. The fact-check additionally increased the sharing of accurate news for self-selected news.

Zusammenfassung / Conclusion

To conclude, content moderation tools are effective in reducing the spread of misinformation, however cannot fully stop them. Since the fact-checks additionally show an impact on respondent's beliefs, it promises a longer-term success.

AutorInnen

Maximilian Guigas, BNITM

Jan Priebe, BNITM

Kerstin Unfried, BNITM