Patient Information and Surgery Decisions: A Discrete Choice Experiment

Surgical treatments are offered more widely than ever before, increasingly to older and high-risk patients. However, it is unclear whether patients making surgical decisions are fully informed about the risks of surgery and the available non-surgical treatments. Especially for high-risk patients, unrecognized elevated post-surgery risks may make non-surgical treatments particularly relevant. In this paper, we study the role of information provision and the availability of non-surgical treatments for high-risk patients considering hip replacement surgery in the UK. We develop a discrete choice model of incorrect beliefs about post-surgery outcomes and limited availability of non-surgical treatments, which we estimate using an online choice experiment. In the experiment, participants take the perspective of a hypothetical high-risk patient; we elicit their beliefs about post-surgery outcomes and randomize additional information about these outcomes and the availability of physiotherapy. We find that beliefs differ systematically from predicted post-surgery outcomes and that the provision of additional information has heterogeneous effects on belief accuracy. We show that excluding physiotherapy from the available treatments accounts for four-fifths of the participants' total welfare loss, while incorrect beliefs about post-surgery outcomes account for the remainder. We find evidence that education is a strong predictor of welfare loss from incorrect beliefs.