Peer effects on compliance with extortive requests.
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ABSTRACT:
SUBMITTER: Andrighetto G
PROVIDER: S-EPMC7182209 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
Publications
Peer effects on compliance with extortive requests.
Andrighetto Giulia G Grieco Daniela D
PloS one 20200424 4
We conduct laboratory experiments to study peer effects on compliance with extortive requests. To this aim, we use an "extortion game" with multiple victims. In agreement with our hypothesis, our results show that when the information on peers' behavior is available, compliance with appropriative requests is triggered by conformism among victims rather than by punishment. Moreover, we find that extorted sums are rather small, requests are proportional to the victim's earnings, similar across vic ...[more]
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Project description:ImportanceAlthough federal law has long promoted patients' access to their protected health information, this access remains limited. Previous studies have demonstrated some issues in requesting release of medical records, but, to date, there has been no comprehensive review of the challenges that exist in all aspects of the request process.ObjectiveTo evaluate the current state of medical records request processes of US hospitals in terms of compliance with federal and state regulations and ease of patient access.Design, setting, and participantsA cross-sectional study of medical records request processes was conducted between August 1 and December 7, 2017, in 83 top-ranked US hospitals with independent medical records request processes and medical records departments reachable by telephone. Hospitals were ranked as the top 20 hospitals for each of the 16 adult specialties in the 2016-2017 US News & World Report Best Hospitals National Rankings.ExposuresScripted interview with medical records departments in a single-blind, simulated patient experience.Main outcomes and measuresRequestable information (entire medical record, laboratory test results, medical history and results of physical examination, discharge summaries, consultation reports, physician orders, and other), formats of release (pick up in person, mail, fax, email, CD, and online patient portal), costs, and request processing times, identified on medical records release authorization forms and through telephone calls with medical records departments.ResultsAmong the 83 top-ranked US hospitals representing 29 states, there was discordance between information provided on authorization forms and that obtained from the simulated patient telephone calls in terms of requestable information, formats of release, and costs. On the forms, as few as 9 hospitals (11%) provided the option of selecting 1 of the categories of information and only 44 hospitals (53%) provided patients the option to acquire the entire medical record. On telephone calls, all 83 hospitals stated that they were able to release entire medical records to patients. There were discrepancies in information given in telephone calls vs on the forms between the formats hospitals stated that they could use to release information (69 [83%] vs 40 [48%] for pick up in person, 20 [24%] vs 14 [17%] for fax, 39 [47%] vs 27 [33%] for email, 55 [66%] vs 35 [42%] for CD, and 21 [25%] vs 33 [40%] for online patient portals), additionally demonstrating noncompliance with federal regulations in refusing to provide records in the format requested by the patient. There were 48 hospitals that had costs of release (as much as $541.50 for a 200-page record) above the federal recommendation of $6.50 for electronically maintained records. At least 6 of the hospitals (7%) were noncompliant with state requirements for processing times.Conclusions and relevanceThe study revealed that there are discrepancies in the information provided to patients regarding the medical records release processes and noncompliance with federal and state regulations and recommendations. Policies focused on improving patient access may require stricter enforcement to ensure more transparent and less burdensome medical records request processes for patients.
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Project description:IntroductionPeer review is a volunteer process for improving the quality of publications by providing objective feedback to authors, but also presents an opportunity for reviewers to seek personal reward by requesting self-citations. Open peer review may reduce the prevalence of self-citation requests and encourage author rebuttal over accession. This study aimed to investigate the prevalence of self-citation requests and their inclusion in manuscripts in a journal with open peer review.MethodsRequests for additional references to be included during peer review for articles published between 1 January 2017 and 31 December 2018 in BMC Medicine were evaluated. Data extracted included total number of self-citations requested, self-citations that were included in the final published manuscript and manuscripts that included at least one self-citation, and compared with corresponding data on independent citations.ResultsIn total, 932 peer review reports from 373 manuscripts were analysed. At least one additional citation was requested in 25.9% (n = 241) of reports. Self-citation requests were included in 44.4% of reports requesting additional citations (11.5% of all reports). Requests for self-citation were significantly more likely than independent citations to be incorporated in the published manuscript (65.1% vs 52.1%; chi-square p = 0.003). At the manuscript level, when requested, self-citations were incorporated in 76.6% of manuscripts (n = 72; 19.3% of all manuscripts) compared with 68.5% of manuscripts with independent citation requests (n = 102; 27.3% of manuscripts). A significant interaction was observed between the presence of self-citation requests and the likelihood of any citation request being incorporated (100% incorporation in manuscripts with self-citation requests alone versus 62.7-72.2% with any independent citation request; Fisher's exact test p<0.0005).ConclusionsRequests for self-citations during the peer review process are common. The transparency of open peer review may have the unexpected effect of encouraging authors to incorporate self-citation requests by disclosing peer reviewer identity.
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Project description:BackgroundContact investigation is an important tool to identify unrecognized patients who are colonized with antibiotic-resistant bacteria. Many Dutch hospitals include already discharged contact patients by sending them a self-sampling request at home, incl. an information letter and sampling materials. Each hospital composes these information letters on their own initiative, however, whether discharged patients comprehend and comply with these requests remains unclear. Therefore, the aim was to provide insight into patients' comprehension of and self-reported compliance with self-sampling requests post-discharge.MethodsThis mixed-methods study was performed in eight Dutch hospitals. First, the Common European Framework of Reference (CEFR) language level of self-sampling request letters was established. Second, a questionnaire about patients' comprehension of the letter, self-reported compliance, and reasons for compliance or non-compliance were sent to patients that received such a request in 2018/2019. Finally, a random selection of questionnaire respondents was interviewed between January and March 2020 to gain additional insights.ResultsCEFR levels of 15 letters were established. Four letters were assigned level B1, four letters B1-B2, and seven letters B2. The majority of patients reported good comprehension of the letter they had received. Conversely, some respondents indicated that information about the bacterium (18.4%), the way in which results would be communicated (18.1%), and the self-sampling instructions (9.7%) were (partially) unclear. Furthermore, self-reported compliance was high (88.8%). Reasons to comply were personal health (84.3%), the health of others (71.9%), and general patient safety (96.1%). Compliant patients appeared to have a need for confirmation, wanted to protect family and/or friends, and felt they were providing the hospital the ability to control the transmission of antibiotic-resistant bacteria. Although a limited number of non-compliant patients responded to the questionnaire, it seemed that more patients did not comply with self-sampling requests when they received a letter in a higher CEFR-level (B2) compared to a lower CEFR-level (< B2) (9.8% vs. 2.5%, P = 0.049).ConclusionsThis study showed an overall good comprehension of and high self-reported compliance with self-sampling requests post-discharge. Providing balanced information in self-sampling request letters has the potential to reduce patient's ambiguity and concerns, and can cause increased compliance with self-sampling requests.
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Project description:This quasi-experimental study estimates academic peer effects in China's middle school (7th–9th grade) classrooms, using data from a large-scale nationally representative survey of middle schoolers in China. Our study design circumvents endogenous sorting by focusing on 52 schools that randomly assigned incoming 7th graders to different 7th-grade classes. Further, reverse causality is addressed by regressing students' 8th-grade test scores on their (randomly assigned) classmates' average 7th-grade test scores. Our analysis reals that all else equal, a one-standard-deviation increase in (8th-grade) classmates' average 7th-grade test scores raises an individual student's 8th-grade mathematics and English test scores, respectively, by 0.13–0.18 and 0.11–0.17 standard deviations. These estimates remain stable when peer characteristics examined in related peer-effect studies are included in the model. Further analysis reveals that peer effects work through raising individual students' time spent studying per week and their confidence in learning. Finally, classroom peer effects are found to be heterogeneous across subgroups: larger for boys, academically stronger students, students attending better schools (i.e., schools with smaller classes and urban schools), and students with relatively disadvantaged family backgrounds (e.g., lower levels of parental education and family wealth).
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Project description:BackgroundBecause of internet searches, advice from friends, and pharmaceutical advertising, especially direct-to-consumer advertising, patients are increasingly activated to request medications during a physician encounter.ObjectivesTo estimate the effect of patient requests for medications on physician-prescribing behavior, unconfounded by patient, physician, and practice-setting factors.Research designTwo experiments were conducted among 192 primary care physicians, each using different video-based scenarios: an undiagnosed "patient" with symptoms strongly suggesting sciatica, and a "patient" with already diagnosed chronic knee osteoarthritis. Half of patients with sciatica symptoms requested oxycodone, whereas the other half requested something to help with pain. Similarly, half of knee osteoarthritis patients specifically requested celebrex and half requested something to help with pain.SubjectsTo increase generalizability and ensure sufficient numbers were available, we recruited 192 primary care physicians from 6 US states.MeasuresThe primary outcome was whether physicians would accede to a patient's request for a medication. Alternative pain medications prescribed were secondary outcomes.Results19.8% of sciatica patients requesting oxycodone would receive a prescription for oxycodone, compared with 1% of those making no specific request (P = 0.001). Fifty-three percent of knee osteoarthritis patients requesting celebrex would receive it, compared with 24% of patients making no request (P = 0.001). Patients requesting oxycodone were more likely to receive a strong narcotic (P = 0.001) and less likely to receive a weak narcotic (P = 0.01). Patients requesting celebrex were much less likely to receive a nonselective nonsteroidal anti-inflammatory drugs (P = 0.008). No patient attributes, physician, or organizational factors influenced a physician's willingness to accede to a patient's medication request.ConclusionsIn both scenarios, activated patient requests for a medication substantially affected physician-prescribing decisions, despite the drawbacks of the requested medications.
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Project description:This study empirically demonstrates significant regional peer effects due to tax avoidance. We used peer companies' idiosyncratic stock returns as an instrumental variable to address potential endogeneity problems. The heterogeneity analysis indicates that for companies with a stronger intensity of regional tax collection and management, a higher degree of informatization, and companies with a low management shareholding ratio, the regional peer effects of enterprise tax avoidance are more significant. Finally, we determined that the managers' information learning, reputation consideration, and information communication are key mechanisms propagating peer effects. The conclusions of this paper enrich and expand the peer effect theory of corporate tax avoidance, thereby providing a theoretical basis and empirical evidence for tax authorities in supervising corporate tax avoidance.
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Project description:This study evaluated hypothesized effects of the Peer-Led Team Learning (PLTL) instructional model on undergraduate peer leaders' critical thinking skills. This investigation also explored peer leaders' perceptions of their critical thinking skills. A quasi-experimental pre-test/post-test with control group design was used to determine critical thinking gains in PLTL/non-PLTL groups. Critical thinking was assessed using the California Critical Thinking Skills Test (CCTST) among participants who had previously completed and been successful in a mixed-majors introductory biology course at a large, private research university in the American Northeast. Qualitative data from open-ended questionnaires confirmed that factors thought to improve critical thinking skills such as interaction with peers, problem solving, and discussion were perceived by participants to have an impact on critical thinking gains. However, no significant quantitative differences in peer leaders' critical thinking skills were found between pre- and post-experience CCTST measurements or between experimental and control groups.
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Project description:Background:It is not convenient or always possible to address parent requests for prescription refills after hours. The primary objective of this quality improvement study was to decrease the number of refill requests received outside of regular business hours. A secondary objective was to reduce the negative effects of call fatigue and related exhaustion for physicians taking calls. Methods:Voluntary participation in this quality improvement project was solicited from the Child Neurology Division at a single academic, tertiary, metropolitan children's hospital. Study design was developed from a project charter, fishbone diagram, process map, driver diagram, and plan-do-study-act worksheet. A peer-reviewed letter was mailed to all clinic patient families and signs were displayed in the clinic space as notification of a policy change. A peer-reviewed script was provided to the Children's Mercy Contact Center triage personnel addressing after-hours refill requests. The number of refill requests received during each after-hours call shift was recorded from April 1, 2015, to March 31, 2016, with a primary outcome measure of the monthly number of refill requests. Results:Postintervention, the average number of refill requests after hours decreased by 39% from 21 to 11 per month (p = 0.0055). Conclusions:This simple intervention has promise to limit prescription refill requests made after hours and improve physician quality of life. Continued data collection will help establish the sustainability of the effect made by this intervention.
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