Overconfident health workers provide lower quality healthcare

Roxanne J. Kovacs, Mylene Lagarde and John Cairns

LSE Research Online Documents on Economics from London School of Economics and Political Science, LSE Library

Abstract: While a growing body of evidence suggests that healthcare workers in low and middle-income countries often provide poor quality of care, the reasons behind such low performance remain unclear. The literature on medical decision-making suggests that cognitive biases, or failures related to the way healthcare providers think, explain many diagnostic errors. This study investigates whether one cognitive bias, overconfidence, defined as the tendency to overestimate one's performance relative to others, is associated with the low quality of care provided in Senegal. We link survey data on the overconfidence of health workers to objective measures of the quality of care they provide to standardised patients – enumerators who pose as real patients and record details of the consultation. We find that about a third of providers are overconfident – meaning that they overestimate their own abilities relative to their peers. We then show that overconfident providers are 26% less likely to manage patients correctly and exert less effort in clinical practice. These results suggest that the low levels of quality of care observed in some settings could be partly explained by the cognitive biases of providers, such as overconfidence. Policies that encourage adequate supervision and feedback to healthcare workers might reduce such failures in clinical decision-making.

Keywords: cognitive bias; medical decision making; overconfidence; overplacement; quality of care; Senegal; standardised patients (search for similar items in EconPapers)
JEL-codes: D01 I10 (search for similar items in EconPapers)
Pages: 11 pages
Date: 2020-01-01
New Economics Papers: this item is included in nep-cbe, nep-hea and nep-neu
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (9)

Published in Journal of Economic Psychology, 1, January, 2020, 76. ISSN: 0167-4870

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Persistent link: https://EconPapers.repec.org/RePEc:ehl:lserod:102673

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