Original
Managing noise through nudges: a mixed methods study on decision-hygiene in public management
Abstract
Nudging interventions can enhance expert decision-making in public management, improving resource use and equity. Using a parallel mixed-methods design, we experimentally tested 2,763 healthcare professionals’ prescribing decisions. Results show physicians are susceptible to systematic errors (i.e. bias) and exhibit variation in choices when presented with the same case (i.e. level noise), but their choices are influenced in the desired direction by guidelines, cost information, command-and-control mechanisms, reduction targets, and social comparisons. Nudges effectively reduce or redirect between-subjects variability. We also compare two noise measures: equality in distribution versus standard deviation. Semi-structured interviews with 36 healthcare managers explored real-world applications of educative and architectural nudges and root causes of noise.
中文
通过助推管理噪声：公共管理中决策卫生的混合方法研究
摘要
助推干预能够增强公共管理中的专家决策，改善资源利用与公平性。我们采用并行混合方法设计，对2763名医疗卫生专业人员的处方决策进行了实验测试。结果表明，医生容易受到系统性错误（即偏差）的影响，并且在面对相同案例时会表现出选择差异（即水平噪声），但他们的选择会因指南、成本信息、命令—控制机制、削减目标和社会比较而朝着期望方向转变。助推能有效减少或重新引导被试间变异。我们还比较了两种噪声测量方式：分布平等与标准差。对36名医疗卫生管理者的半结构化访谈探讨了教育型与架构型助推在现实中的应用以及噪声的根本原因。
关键词
助推、决策卫生、噪声、混合方法、公共管理、医疗卫生专业人员、处方决策、行为公共管理