Admission Control Bias and Path-Dependent Feedback Under Diagnosis Uncertainty

35 Pages Posted: 21 Apr 2021

See all articles by Song-Hee Kim

Song-Hee Kim

Seoul National University - Business School

Jordan Tong

Wisconsin School of Business

Date Written: April 21, 2021

Abstract

Problem definition: Do physicians exhibit predictable behavioral bias when making admission control decisions under patient diagnoses uncertainty with stochastic arrivals and length-of-stays? How can we structure feedback to help improve their decision-making?

Methodology/results: We use a behavioral model to theorize how a diagnosis anchoring and insufficient adjustment heuristic may lead to an over-rationing bias, and hypothesize when this bias is greatest. We then propose that feedback for rejected patients -- above and beyond feedback for admitted patients -- is critical for mitigating this bias. This is because feedback for admitted patients only may suffer from a type of path-dependency that prevents decision-makers from receiving the most helpful dis-confirming feedback. We provide evidence supporting these hypotheses using pre-registered experiments in which medical students or Amazon Mechanical Turk workers manage admissions for simulated hospital units.

Managerial implications: Our results (1) illuminate an important anchoring bias in admission control under diagnosis uncertainty, (2) identify rejected patient feedback as a critical component for mitigating this bias, and (3) provide insight into the circumstances under which these phenomena are likely to be most significant.

Keywords: healthcare operations, behavioral operations, laboratory experiments, admission control, diagnostic uncertainty, system neglect, base rate neglect, feedback

Suggested Citation

Kim, Song-Hee and Tong, Jordan, Admission Control Bias and Path-Dependent Feedback Under Diagnosis Uncertainty (April 21, 2021). Available at SSRN: https://ssrn.com/abstract=3830905 or http://dx.doi.org/10.2139/ssrn.3830905

Song-Hee Kim (Contact Author)

Seoul National University - Business School ( email )

Seoul
Korea, Republic of (South Korea)

Jordan Tong

Wisconsin School of Business ( email )

975 University Avenue
Madison, WI 53706
United States

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