Behavioural economics workshop takeaways: Leading the way to better health by improving intuitive decisions

20 August 2018

Helping healthcare managers, planners and policymakers to understand and successfully apply behavioural economics to solve sector and system challenges and improve decision-making was the focus of a workshop hosted by The University of Queensland’s Centre for the Business and Economics of Health (CBEH) on 7 August.

The workshop, Nudging our way to more efficient healthcare: Unleashing the potential of behavioural economics, featured eight leading economic, business and psychology experts from UQ and QUT, as well as a keynote presentation by Associate Professor Adam Oliver from the London School of Economics and Political Science.

During the day, the distinguished speakers shared their latest research, extensive experience and relevant case studies with participants, demonstrating the concepts and practices of designing behavioural interventions for better health, and discussing the strengths and limitations of applying these behavioural frameworks.

The workshop consisted of five sessions, each focusing on a key aspect of behavioural economics.

Below, you can read some of the key learnings and takeaways from the day, as shared by UQ CBEH postdoctoral researchers Dr Marcin Sowa and Dr Nancy Kong.

Session 1: Behavioural economics: What it is and what it is not

  • Behavioural economics is a rising field of research that employs psychological insights and methods to study the consequences of resource allocation decisions. Its ability to nudge people toward making slightly better everyday choices contrasts with large-scale government interventions aimed at correcting market imperfections, which have been the focus of mainstream economics for decades.
  • Strong cognitive biases exist in everyday life, making our momentary decisions sub-optimal because we make decisions based on imperfect information.
  • The essence of nudging policy is libertarian paternalism, according to which the liberty of choice remains with the individual. Meanwhile, paternalism enables the government to ‘nudge’ people to choose better alternatives for themselves.
  • Nudging policy target individual internalities, liberty and behaviour. This is in contrast to the traditional economic policy, which focuses on external effects.
  • A behavioural economics success story is organ donation, where organ donations could be improved from 20% to 80% when the system changed from "opt in" to "opt out”.

Session 2: Changing the behaviour of the public: Influencing needs

  • It is difficult to remove the presence of bad social norms from society, even when most people agree on their undesirability.
  • Pluralistic ignorance (imperfect information) traps people in bad social norms.
  • Social media may help to voice the true social preferences that are otherwise hard to reveal.
  • In a recent study, an intervention involving a written promise and receiving an upfront gift did not significantly improve school attendance of Australian Indigenous students. Instead, the surprising outcome was a higher rate of excused non-attendance.

Session 3: Changing the behaviour of patients: Influencing demands

  • Gamification nudges people to live a healthier life by the designs similar to video games, which make repetitive and time consuming efforts more engaging. The addictive features of video games can make us perform tedious tasks for hours in exchange for worthless virtual rewards, but is using such reward structures to encourage healthy behaviours effective and ethically justified?
  • External incentives can crowd out internal motivation, have limited long-term effects, and can even be counter-productive. The lack of a lasting effect/behaviour change after incentives are removed from a behavioural intervention remains one of the prevailing challenges of this framework.

Session 4: Changing the behaviour of providers/managers: Influencing supply

  • Applying behavioural mechanisms to correct cognitive bias in medical practitioners can improve their abilities to identify critical information, enhance treatment decisions, and leverage their internal motivations to encourage delivery of better healthcare for patients.
  • A featured example was how cognitive biases lower drivers’ perception of hazards. Driver programs, which can be designed to reduce such biases, are particularly effective when offered to inexperienced drivers.
  • Also discussed were the ethics and psychology behind why some health professionals feel pressured to overtreat patients, which results in sub-optimal allocation of healthcare resources.

Session 5: Whither or wither behavioural economics in health policy?

  • There are many ethical considerations behind behavioural economics, with a major question being ‘Should the government use the same tricks as the commercial for-profit sector to manipulate us into making choices that our rational selves desire but our busy selves fail to deliver?’ This question reflects controversies regarding modifications of the living environment such as the design of city space to make its citizens walk for longer.

View the workshop photo gallery via Flickr.