ECONOMÍA

Economía del comportamiento aplicada I: los proveedores de salud

Fuente: AdForum

En 2017, el Premio Nobel de Economía fue otorgado a Richard Thaler por su aporte a la economía del comportamiento. Este campo de estudio destaca por sus aplicaciones a diversas situaciones reales: cuánto ahorrar, qué tipo de comida elegir o incluso si desinfectar el agua con las pastillas de cloro proporcionadas por algún programa social. En el rubro de la medicina, la economía del comportamiento puede emplearse a través de la “Teoría del Empujón” (Nudge Theory) propuesta por Thaler. Esta consiste en proporcionar incentivos indirectos para influenciar la toma de decisiones de los individuos.

Para un médico, las decisiones que toma día a día son particularmente importantes pues involucran la salud de sus pacientes. No obstante, comportamientos que parecen ser tan racionales como fáciles de adoptar -como lavarse las manos antes de atender a un paciente- pueden ser realizados sin pensar dos veces. Este ejemplo es no sólo un procedimiento estándar y obligatorio, sino también es una de las principales medidas contra la propagación de enfermedades intrahospitalarias. Sin embargo, los proveedores de servicios médicos desinfectan sus manos la mitad de las veces que deberían, en promedio (CDC, 2017).

Grant y Hofmann (2011) descubrieron que un cartel señalando que “La higiene de las manos impide que los demás contraigan enfermedades” era significativamente más efectivo que “La higiene de las manos impide que contraigas enfermedades”. La explicación viene dada por la economía del comportamiento: debido a que los médicos tienden a sobreestimar su inmunidad personal respecto a enfermedades, las estrategias más efectivas serán aquellas enfocadas en las demás personas (Grant y Hofmann, 2011).

En cuanto al tratamiento, la decisión de prescribir medicamentos genéricos equivalentes a los de marca repercute en las finanzas del paciente y las del sistema de salud. Un resultado menos evidente es el de una mayor adherencia al tratamiento provisto (University of Pennsylvania School of Medicine, 2016). Ante ello, proporcionar incentivos para promover el uso de medicamentos genéricos puede ser visto como favorable por algunos actores.

Investigadores de la Escuela de medicina de Perelman encontraron que cambiar la opción por defecto en el Expediente Clínico Electrónico (EMR por sus siglas en inglés) incrementó la prescripción de genéricos. Cuando un médico recetaba una medicina, el EMR prescribía automáticamente el equivalente en versión genérica, lo cual podía revertirse al marcar una casilla que anuncia “prescribir como está escrito”. Dicho cambio fue implementado en todo el sistema de salud de la Universidad de Pensilvania e incrementó la prescripción de medicamentos genéricos de un 75% a 95% (University of Pennsylvania School of Medicine, 2016).

Estos son sólo algunos ejemplos de cómo la economía del comportamiento puede aplicarse a la vida real, particularmente dirigido hacia los proveedores de salud. Este es un campo que sigue desarrollándose y no sorprendería ver más intervenciones de este tipo en el futuro.

Fuentes:

CDC (2017). Hand Hygiene in Healthcare Settings. Centers for Disease Control and Prevention.  (17 de enero de 2018)

Grant, A.; Hofmann, D. (2011). It’s Not All About Me: Motivating Hand Hygiene Among Health Care Professionals by Focusing on Patients. Psychological Science, 22(12), 1494 – 1499.

University of Pennsylvania School of Medicine. (2016, May 9). Changing default prescription settings in EMRs increased rates of generic drugs, study finds: Electronic medical records can be designed to nudge physician behaviorScienceDaily. Retrieved February 3, 2018

Lucía Valdivieso
Estudiante de economía de la Universidad del Pacífico. Amo al Perú y sueño con contribuir a mejorarlo. También me gusta viajar, cocinar y tomar fotos.
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