Present bias and health

Abstract

This study uses a dynamic discrete choice model to examine the degree of present bias and naivete about present bias in individuals' health care decisions. Clinical guidelines exist for several common chronic diseases. Although the empirical evidence for some guidelines is strong, many individuals with these diseases do not follow the guidelines. Using persons with diabetes as a case study, we find evidence of substantial present bias and naivete. Counterfactual simulations indicate the importance of present bias and naivete in explaining low adherence rates to health care guidelines.

Time preferences, diabetes self‐management behaviours and outcomes: a systematic review

“…Five additional articles were excluded after full-text review; three did not explicitly elicit time preferences, one lacked a diabetes-related outcome assessment, and one lacked a subgroup analysis of people with diabetes. A total of 12 articles [34][35][36][37][38][39][40][41][42][43][44][45] were included ( Table 1). Three studies analysed both time-consistent and time-inconsistent preferences [38,40,45], three studies solely analysed time-inconsistent preferences [34,35,39] and six studies did not explicitly define a time preference model [36,38,[41][42][43][44].…”

“…A total of 12 articles [34][35][36][37][38][39][40][41][42][43][44][45] were included ( Table 1). Three studies analysed both time-consistent and time-inconsistent preferences [38,40,45], three studies solely analysed time-inconsistent preferences [34,35,39] and six studies did not explicitly define a time preference model [36,38,[41][42][43][44]. Half of the studies estimated continuous discount rates [34,35,37,39,40,45], while the other half used ordinal measures [36,38,[41][42][43][44].…”

“…Three studies analysed both time-consistent and time-inconsistent preferences [38,40,45], three studies solely analysed time-inconsistent preferences [34,35,39] and six studies did not explicitly define a time preference model [36,38,[41][42][43][44]. Half of the studies estimated continuous discount rates [34,35,37,39,40,45], while the other half used ordinal measures [36,38,[41][42][43][44]. Measured outcomes across studies included self-care activities, such as taking medication, exercising and eating a healthy diet, and biomedical outcomes such as HbA 1c and diabetes-related complications.…”

“…Measured outcomes across studies included self-care activities, such as taking medication, exercising and eating a healthy diet, and biomedical outcomes such as HbA 1c and diabetes-related complications. Eleven studies [34][35][36][37][38][39][40][41][42][43][44] used cross-sectional data; of these, one also used panel data [36] and one study used panel data alone [45]. Two studies included data on insulin pump use [34,35]; however, one study reported only the proportion of participants using an insulin pump [35]; the other study included time preferences and insulin pump use in the same multivariate models but did not report interaction analyses [34].…”

“…Despite the methodological limitations of the included studies, the results indicate that associations exist between time preferences, regardless of elicitation methods and model assumptions, and diabetes self‐management behaviours and outcomes. All but two studies examining associations between time preferences and diabetes self‐care activities found that higher discount rates were associated with less diabetes‐related self‐care . With a single exception , the same negative relationship was observed between time preferences and HbA 1c , while studies of diabetes complications had mixed findings .…”