Library Header Image
LSE Research Online LSE Library Services

Overconfident health workers provide lower quality healthcare

Kovacs, Roxanne J., Lagarde, Mylene ORCID: 0000-0002-5713-2659 and Cairns, John (2020) Overconfident health workers provide lower quality healthcare. Journal of Economic Psychology, 76. ISSN 0167-4870

[img] Text (Overconfidence_manuscript) - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (389kB)

Identification Number: 10.1016/j.joep.2019.102213


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.

Item Type: Article
Official URL:
Additional Information: © 2019 Elsevier B.V.
Divisions: Health Policy
JEL classification: D - Microeconomics > D0 - General > D01 - Microeconomic Behavior: Underlying Principles
I - Health, Education, and Welfare > I1 - Health > I10 - General
Date Deposited: 28 Nov 2019 12:48
Last Modified: 20 Jun 2024 19:42

Actions (login required)

View Item View Item


Downloads per month over past year

View more statistics