This dissertation consists of three essays that study the role of information acquisition and processing in health decision-making. Each chapter underscores the ways in which new information shapes the choices of health providers and consumers. Understanding these responses sheds light on critical health policy problems, including the potential overuse of low-value health services, gaps between medical evidence and practice, and inequitable access to high-value health services. The first essay studies the role of a consumer’s family network in the formation of their risk perceptions. I assess whether people correctly interpret new risk information communicated through household health events and analyze how these responses impact household welfare. Individuals respond to new diagnoses in ways most consistent with individual reevaluations of health risk rather than other possible explanations. To assess welfare implications, I estimate a structural model of health choices in which individuals learn about risk after health events reveal information. I find that consumers over-respond to recent, salient health events by over-weighting their risks ex-post. This leads to individual and social welfare losses, and suggests that aiding consumers in interpreting health risk information should be an important aim of health literacy policies. The second essay explores how health providers respond to information about innovations in mental health treatments, paying particular attention to the heterogeneous adoption costs of different practices. I compare the impact of continuing education on takeup across innovations that incur learning costs (psychotherapy) and those that do not (psychopharmacology). I use a novel extension of an estimator proposed by Calvi et al. (2021) to estimate a dynamic treatment effect in the presence of classification error. Therapists respond more to education when learning costs are negligent, being about three percentage points more likely to write new prescriptions following a conference. The third essay assesses the tradeoff between adopting novel medical technologies and achieving health equity. I study the adoption of transcatheter valve replacement surgeries in Medicare patients; these surgeries disrupted the supply of medical interventions from cardiothoracic surgeons to interventional cardiologists. This transition led providers to adjust practice styles along two margins: medium-risk patients became more likely to receive surgery, and low-risk patients received fewer medical interventions overall. I incorporate these findings into a model of physician decision-making, showing that both the expansion of high-intensity intervention and the crowd-out of low-intensity treatment can be rationalized by the presence of technological spillovers. The model further highlights that crowd-out may be inequitably distributed across the patient population when treatment appropriateness is not directly observed. I validate these predictions in my setting, showing that technology adoption resulted in disproportionately high barriers to care for low-income patients.

<p>This dissertation explores how consumers learn from repeated experiences with a product offering. It develops a new Bayesian consumer learning model, the unstable learning model. This model expands on existing models that explore learning when quality is stable, by considering when quality is changing. Further, the dissertation examines situations in which consumers may act as if quality is changing when it is stable or vice versa. This examination proceeds in two essays.</p><p>The first essay uses two experiments to examine how consumers learn when product quality is stable or changing. By collecting repeated measures of expectation data and experiences, more information enables estimation to discriminate between stable and unstable learning. The key conclusions are that (1) most consumers act as if quality is unstable, even when it is stable, and (2) consumers respond to the environment they face, adjusting their learning in the correct direction. These conclusions have important implications for the formation and value of brand equity.</p><p>Based on the conclusions of this first essay, the second essay develops a choice model of consumer learning when consumers believe quality is changing, even though it is not. A Monte Carlo experiment tests the efficacy of this model versus the standard model. The key conclusion is that both models perform similarly well when the model assumptions match the way consumers actually learn, but with a mismatch the existing model is biased, while the new model continues to perform well. These biases could lead to suboptimal branding decisions.</p> / Dissertation

[pt] O presente trabalho se propõe a desenvolver um modelo de aprendizado do consumidor que contemple as dimensões do aprendente, do processo de aprendizagem e dos resultados obtidos neste aprendizado como melhor forma de entender e gerenciar estes consumidores. Para tal conduziu-se uma revisão bibliográfica e seguindo uma perspectiva interdisciplinar e multidisciplinar, recorreu-se às disciplinas de pedagogia, psicologia e marketing para formular tal modelo. Para avaliar o modelo multidisciplinar de aprendizagem, foi desenvolvida uma ferramenta em ambiente de internet que pudesse avaliar de maneira consistente e objetiva, todas as variáveis do modelo. Como resultado surgiram proposições que foram avaliadas em entrevistas com especialistas e correlacionadas a literatura existente. É objetivo deste trabalho entender melhor estes usuários, quer sejam consumidores de e- commerce ou não e poder melhor gerir o processo de aprendizado dos mesmos, algo novo e que terá impacto significativo no sucesso das organizações neste novo milênio. / [en] The purpose of the present dissertation is to develop a consumer learning model that involves multidimensional aspects, considering the learner, the process of learning and the result of learning. This model also should allow to understand and manage these consumers. In this sense, the literature review was provided and according to a standpoint which is both inter and multidisciplinary, contributions from several disciplines like Pedagogy, Psychology and Marketing oriented the construction of the model. In order to evaluate the multidimensional model, a tool was developed in internet environment, considering all variables of the model, consistently and objectively. As result, propositens were originated and evaluated by specialists, in qualitative interviews, and related to the literature review. As result of this dissertation, the better understanding of internet users, consumers or not, can be provided in order to manage their learning process, which is something new and can promote significant impact in organizational success in this new millennium.

In the first chapter of my thesis, I examine a domestic downstream producer that acquires a foreign input supplier with the aim of manipulating the transfer price and shifting profits from a high-tax to a low-tax country. The United States, with a corporate tax rate of 21%, is the leading example of profit shifting behavior, where multinational enterprises like Google, Apple and Facebook shift part of their profits to tax havens like Ireland, the Netherlands, or Switzerland. In our model, the multinational enterprise faces a trade-off: insourcing the input at a high transfer price reduces the corporate tax burden but at the cost of increasing the input cost of its downstream division, which reduces domestic sales and profits. The optimal transfer price balances this trade-off. In an extension that we develop in the model, the regulation under the arm’s length principle is shown to reduce the transfer price, which reduces distortion in the domestic production and expands the region in which vertical FDI benefits consumers and social welfare in the home country. We also show that promoting downstream competition could help align private and social incentives, reinforcing the positive effects of regulation. In the second chapter, I study the effect of consumer learning on shrouding (hiding information about the product price) and pricing strategies of the firms in add-on markets. The presence of consumer myopia in add-on markets often allows firms to exploit consumers who have limited information about the market, even in competitive ones. I formally develop a dynamic theoretical model of add-on markets where consumers learn about the shrouding strategies of firms after they buy and experience expensive add-on products in a previous period. Despite high levels of consumer myopia, I find that firms choose to unshroud the add-on product and sell it at a low price as long as consumer experience is high enough in the market. I also find co-existence of shrouding and unshrouding equilibria with high add-on prices when the level of consumer experience is low enough and the level of consumer myopia is high enough in the market. The results combine the contrasting results in the literature for add-on markets (Gabaix and Laibson (2006) and Dahremoller (2013)), and are robust to an infinite-period extension of the model. In the third chapter, I formally develop a theoretical model of the market for quacks, where market consists of both firms which provide a useless service and some experts. Apart from the naive consumers who sample firms based on anecdotal reasoning, I introduce some consumers who use Bayesian updating based on the distribution of firms in the market (sophistication), and hence can infer some information about firms based on the signals they receive, and study its effect on the behavior of firms in the market. In this setting, I find a Bayesian mixed-strategy Nash equilibrium, in which firms choose to randomize over low prices and sell their services to naive and sophisticated consumers, as long as there is a significant fraction of consumers who update their information based on the distribution of the firms in the market. The higher is the quality of service provided by the expert, the larger is the region in which this Nash equilibrium prevails. In contrast, if the fraction of consumers with incorrect beliefs is high enough, firms sell their services at high prices in equilibrium and only to the latter type of consumers. I extend the benchmark model to include more than one quack (and more than one expert), and the results are shown to be robust to the extensions. When there are two quacks and two experts, I find that firms may ‘split’ the market, and sell their services at different prices.

Thesis (PhD (Education)--University of Stellenbosch, 2006. / 287 leaves printed as single pages, preliminary pages i-xxii and numbered pages 1-253. Includes bibliography and appendixes. Digitized at 600 dpi grayscale to pdf format (OCR), using a Bizhub 250 Konica Minolta Scanner. / ENGLISH ABSTRACT: This study is aimed at developing a curriculum framework for consumer learning at a higher education institution, using a case study design. To determine the need for consumer learning at the Cape Peninsula University of Technology - the "bounded context" of the study - a situation analysis was conducted as the first phase of curriculum development. Methods to triangulate data included the use of quantitative and qualitative research methods, together with a thorough literature study. The two sets of empirical data were obtained from two research instruments, namely self-administered survey questionnaires and semistructured interviews with learning facilitators (lecturers) at the institution. The survey amongst first-year students was used to assist in the needs assessment for curriculum development at the CPUT and to determine the knowledge, skills, values and attitudes of first-year respondents regarding consumer rights and responsibilities, as well as other consumer-related issues. This not only provided data to analyse the situation, but also assisted in the planning and development of a curriculum framework for consumer learning. The researcher used semi-structured interviews to determine the views and perceptions of learning facilitators regarding the importance of consumer learning, and to gauge the need for such learning at the institution. Aspects relating to the contents, teaching strategies, level of introduction, potential for critical crossfield outcomes development, benefits and major obstacles in the implementation and/or integration into the curriculum were also investigated. The two-tiered situation analysis indicated that students expressed a clear need for consumer learning at the Cape Peninsula University of Technology, especially regarding the areas of consumer rights and responsibilities. The importance of consumer learning and the "readiness climate" from the perspective of the learning facilitators was also clearly established. The study culminated in the development of a curriculum framework for consumer learning that is compatible with the requirements of the South African Qualifications Authority and the Higher Education Qualifications Framework in South Africa. Key findings reported in the form of a curriculum framework could serve as a guideline for the planning and implementation of a consumer learning programme at the Cape Peninsula University of Technology. / AFRIKAANSE OPSOMMING: Hierdie studie is onderneem met die doel om 'n kurrikulumraamwerk vir verbruikersleer aan 'n hoëronderwysinstelling te ontwikkel. 'n Gevallestudiebenadering is gebruik om die sosiale verskynsel van verbruikersleer te ondersoek. Om die behoefte aan verbruikersleer aan die Kaapse Skiereilandse Universiteit van Tegnologie - die konteks van die studie - te bepaal, is 'n situasie-analise onderneem as die eerste fase van kurrikulumontwikkeling. Metodes van triangulasie in hierdie navorsing sluit die benutting van kwantitatiewe en kwalitatiewe gegewens in, asook 'n literatuurstudie. Die twee stelle empiriese gegewens is verkry vanuit 'n selfgeadministreerde opnamevraelys aan studente en onderhoude met leerfasiliteerders (dosente) aan die instelling. Die doel van die opnamevraelys was om te help met die behoeftebepaling vir kurrikulumontwikkeling aan die Kaapse Skiereilandse Universiteit van Tegnologie, en veral om die kennis, vaardighede, waardes en houdings van eerstejaarrespondente met betrekking tot verbruikersregte en -verantwoordelikhede te bepaal. Dit het nie alleen insig in die situasie-ontleding gegee nie, maar het ook gehelp met die beplanning en ontwikkeling van 'n kurrikulumraamwerk vir verbruikersleer. Die doel met die gebruik van semi-gestruktureerde onderhoude in hierdie studie was om die navorser in staat te stel om die sienswyse en persepsies van leerfasiliteerders met betrekking tot die belangrikheid van verbruikersleer, asook die behoefte daarvoor by die instelling te bepaal. Aspekte wat verband hou met die inhoud, onderrigstrategieë, vlak van bekendstelling, potensiaal vir kritieke uitkomsontwikkeling, voordele en vernaamste struikelblokke in die implementering en/of integrasie van die kurrikulum is ook getoets. Die situasie-analise dui daarop dat studente aan die Kaapse Skiereilandse Universiteit van Tegnologie 'n behoefte het aan verbruikersleer, veral met betrekking tot die bevordering van verbruikersregte en -verantwoordelikhede. Die belangrikheid van verbruikersleer en die "gereedheidsklimaat" daarvoor vanuit die perspektief van die leerfasiliteerders is ook bevestig. Die resultaat van die navorsing het gelei tot die ontwikkeling van 'n kurrikulumraamwerk vir verbruikersleer wat versoenbaar is met die vereistes van die Suid-Afrikaanse Kwalifikasie-Owerheid en die van die Hoëronderwys Kwalifikasieraamwerk in Suid-Afrika. Sleutelbevindings in verband met verbruikersleer is ook in die raamwerk opgeneem. Hierdie bevindings kan as 'n riglyn dien vir die beplanning en implementering van 'n verbruikersleerprogram aan die Kaapse Skiereilandse Universiteit van Tegnologie.