Understanding Physicians’ Use of Decision Support: Evidence From a Behavioral Experiment

Abstract

Enabling physicians to use decision support (DS) tools to gather additional information for therapy recommendations has the potential to positively impact the quality of care. We examine how resource constraints affect physicians' willingness to use DS and the subsequent impact on therapeutic decision-making. In a controlled field experiment involving 247 German pediatricians, participants decide on the duration of antibiotic therapy for 40 routine pediatric cases. We exogenously vary three factors: DS availability, information-gathering costs, and quality incentives. Findings show that higher information-gathering costs reduce physicians' likelihood of using DS, while quality incentives are insufficient to offset the negative effects of resource constraints. DS use improves the appropriateness of therapeutic decisions in cases of undertreatment, while overtreatment persists even after DS use. Our study suggests that alleviating resource constraints could improve DS use and the appropriateness of therapeutic decisions. Moreover, it challenges the effectiveness of conventional policy initiatives aimed at improving prescribing practices.