边际诊断的家庭溢出效应：以多动症为例
Family Spillover Effects of Marginal Diagnoses: The Case of ADHD
American Economic Journal: Applied Economics · 2025 · [{"name": "Petra Persson", "affiliation": []}, {"name": "Xinyao Qiu", "affiliation": []}, {"name": "Maya Rossin‐Slater", "affiliation": ["Stanford University"]}]
中文摘要
医疗保健体系在许多场合使用患者的家族病史，这一做法被广泛认为能够提高医疗资源配置的效率。本文通过说明对遗传信息的依赖可能放大低价值医疗的错配，对这一观点提出了反面证据。我们以注意缺陷多动障碍为研究对象，表明对家族病史的依赖会产生一种“滚雪球效应”——即最初的边际诊断向患者亲属的传播。这种滚雪球效应提高了低价值医疗的私人成本与社会成本。(JEL H51, I12, I13, I18, J12, J13)
Abstract
The health care system uses patient family medical history in many settings, and this practice is widely believed to improve the efficiency of health care allocation. This paper provides a counterpoint by documenting that reliance on hereditary information can amplify the misallocation of low-value care. We study Attention Deficit Hyperactivity Disorder and show that reliance on family medical history generates a “snowball effect”—the propagation of an original marginal diagnosis to a patient’s relatives. This snowball effect raises the private and social costs of low-value care. (JEL H51, I12, I13, I18, J12, J13)