Long-Run Effects of Temporary Incentives on Medical Care Productivity

The adoption of new clinical practice patterns by medical care providers is often challenging, even when the patterns are believed to be efficacious and profitable. This paper uses a randomized field experiment to examine the effects of temporary f...

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Main Authors:	Celhay, Pablo, Gertler, Paul, Giovagnoli, Paula, Vermeersch, Christel
Format:	Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2015
Subjects:	PREMATURE BIRTH PHARMACY CHILD HEALTH BIRTH RISKS TREATMENT PERSONALITY PHYSICIAN FINANCING PHARMACISTS ANTENATAL CARE INCOME QUALITY OF HEALTH CARE PSYCHOLOGY PREVENTION DOCTORS HEALTH ECONOMICS MORBIDITY COMMUNITY HEALTH PRIMARY CARE PEDIATRICS HEALTH INSURANCE PRENATAL CARE HEALTH CARE MEDICAL RECORDS PREVENTIVE MEDICINE BIRTH CONTROL EFFECTS HEALTH CARE FACILITIES INCENTIVES SLEEP HEALTH HEALTH PROFESSIONALS HEALTH WORKERS SMOKERS HYPERTENSION HEALTH FACILITIES PUBLIC HEALTH HEALTH CONDITIONS QUALITY OF HEALTH RANDOMIZED CONTROLLED TRIALS ANEMIA HEALTH SECTOR KNOWLEDGE CHOICE DIABETES PREGNANT WOMAN HEALTH TARGETS PAIN WORKPLACE COSTS MEDICAL SCIENCE PILL LIFE PATIENT PATIENTS HOSPITAL RECORDS SMOKING INTERVENTION BIRTH WEIGHT PROBABILITY SEROLOGY PUBLIC HEALTH CARE FIXED COSTS PUBLIC HOSPITALS NURSES OBSERVATION TETANUS MARKETING MEDICAL CARE HOSPITAL PERSONNEL SYMPTOMS HEALTH ORGANIZATION SCREENING INTERVIEW MORTALITY GENERAL PRACTICE MEDICAL TREATMENT CANCER HIV TESTING MEDICAL EDUCATION EQUITY WORKERS HIV CARE HEALTH POLICY MEDICINE HEALTH OUTCOMES DEMAND DIARRHEA HYGIENE OLDER CHILDREN MEDICAL PERSONNEL HEALTH CLINICS CLINICAL PRACTICE MEASUREMENT NUTRITION MEDICAL OFFICER ADOLESCENTS PRIMARY HEALTH CARE PNEUMONIA HEALTH RESULTS INSURANCE WEIGHT PHYSICIANS PREGNANT WOMEN OBESITY EXERCISE CHILDREN CLINICAL TRIALS DISEASE CLINICS EVALUATION LOW BIRTH WEIGHT ILLNESS WELLNESS GENERAL PRACTITIONERS ADDICTION INFECTIONS COUNSELING ALL REHABILITATION POPULATION MATERNAL AND CHILD HEALTH WEIGHT LOSS SMOKING CESSATION NEWBORN HEALTH FEES EPIDEMIOLOGY CHILD HEALTH SERVICES VACCINE HOSPITALS MEDICAID HEALTH PROGRAMS HEALTH SERVICES IMPLEMENTATION PREGNANCY MEDICAL SCHOOLS
Online Access:	http://documents.worldbank.org/curated/en/2015/06/24736285/long-run-effects-temporary-incentives-medical-care-productivity http://hdl.handle.net/10986/22228

id	okr-10986-22228
recordtype	oai_dc
spelling	okr-10986-222282021-04-23T14:04:07Z Long-Run Effects of Temporary Incentives on Medical Care Productivity Celhay, Pablo Gertler, Paul Giovagnoli, Paula Vermeersch, Christel PREMATURE BIRTH PHARMACY CHILD HEALTH BIRTH RISKS TREATMENT PERSONALITY PHYSICIAN FINANCING PHARMACISTS ANTENATAL CARE INCOME QUALITY OF HEALTH CARE PSYCHOLOGY PREVENTION DOCTORS HEALTH ECONOMICS MORBIDITY COMMUNITY HEALTH PRIMARY CARE PEDIATRICS HEALTH INSURANCE PRENATAL CARE HEALTH CARE MEDICAL RECORDS PREVENTIVE MEDICINE BIRTH CONTROL EFFECTS HEALTH CARE FACILITIES INCENTIVES SLEEP HEALTH HEALTH PROFESSIONALS HEALTH WORKERS SMOKERS HYPERTENSION HEALTH FACILITIES PUBLIC HEALTH HEALTH CONDITIONS QUALITY OF HEALTH RANDOMIZED CONTROLLED TRIALS ANEMIA HEALTH SECTOR KNOWLEDGE CHOICE DIABETES PREGNANT WOMAN HEALTH TARGETS PAIN WORKPLACE COSTS MEDICAL SCIENCE PILL LIFE PATIENT PATIENTS HOSPITAL RECORDS SMOKING INTERVENTION BIRTH WEIGHT PROBABILITY SEROLOGY PUBLIC HEALTH CARE FIXED COSTS PUBLIC HOSPITALS NURSES OBSERVATION TETANUS MARKETING MEDICAL CARE HOSPITAL PERSONNEL SYMPTOMS HEALTH ORGANIZATION SCREENING INTERVIEW MORTALITY GENERAL PRACTICE MEDICAL TREATMENT CANCER HIV TESTING MEDICAL EDUCATION EQUITY WORKERS HIV CARE HEALTH POLICY MEDICINE HEALTH OUTCOMES DEMAND DIARRHEA HYGIENE OLDER CHILDREN MEDICAL PERSONNEL HEALTH CLINICS CLINICAL PRACTICE MEASUREMENT NUTRITION MEDICAL OFFICER ADOLESCENTS PRIMARY HEALTH CARE PNEUMONIA HEALTH RESULTS INSURANCE WEIGHT PHYSICIANS PREGNANT WOMEN OBESITY EXERCISE CHILDREN CLINICAL TRIALS DISEASE CLINICS EVALUATION LOW BIRTH WEIGHT ILLNESS WELLNESS GENERAL PRACTITIONERS ADDICTION INFECTIONS COUNSELING ALL REHABILITATION POPULATION MATERNAL AND CHILD HEALTH WEIGHT LOSS SMOKING CESSATION NEWBORN HEALTH FEES EPIDEMIOLOGY CHILD HEALTH SERVICES VACCINE HOSPITALS MEDICAID HEALTH PROGRAMS HEALTH SERVICES IMPLEMENTATION PREGNANCY MEDICAL SCHOOLS The adoption of new clinical practice patterns by medical care providers is often challenging, even when the patterns are believed to be efficacious and profitable. This paper uses a randomized field experiment to examine the effects of temporary financial incentives paid to medical care clinics for the initiation of prenatal care in the first trimester of pregnancy. The rate of early initiation of prenatal care was 34 percent higher in the treatment group than in the control group while the incentives were being paid, and this effect persisted at least 15 months and likely 24 months or more after the incentives ended. These results are consistent with a model where the incentives enable providers to address the fixed costs of overcoming organizational inertia in innovation, and suggest that temporary incentives may be effective at motivating improvements in long-run provider performance at a substantially lower cost than permanent incentives. 2015-07-17T21:22:47Z 2015-07-17T21:22:47Z 2015-06 Working Paper http://documents.worldbank.org/curated/en/2015/06/24736285/long-run-effects-temporary-incentives-medical-care-productivity http://hdl.handle.net/10986/22228 English en_US Policy Research Working Paper;No. 7348 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Policy Research Working Paper
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	PREMATURE BIRTH PHARMACY CHILD HEALTH BIRTH RISKS TREATMENT PERSONALITY PHYSICIAN FINANCING PHARMACISTS ANTENATAL CARE INCOME QUALITY OF HEALTH CARE PSYCHOLOGY PREVENTION DOCTORS HEALTH ECONOMICS MORBIDITY COMMUNITY HEALTH PRIMARY CARE PEDIATRICS HEALTH INSURANCE PRENATAL CARE HEALTH CARE MEDICAL RECORDS PREVENTIVE MEDICINE BIRTH CONTROL EFFECTS HEALTH CARE FACILITIES INCENTIVES SLEEP HEALTH HEALTH PROFESSIONALS HEALTH WORKERS SMOKERS HYPERTENSION HEALTH FACILITIES PUBLIC HEALTH HEALTH CONDITIONS QUALITY OF HEALTH RANDOMIZED CONTROLLED TRIALS ANEMIA HEALTH SECTOR KNOWLEDGE CHOICE DIABETES PREGNANT WOMAN HEALTH TARGETS PAIN WORKPLACE COSTS MEDICAL SCIENCE PILL LIFE PATIENT PATIENTS HOSPITAL RECORDS SMOKING INTERVENTION BIRTH WEIGHT PROBABILITY SEROLOGY PUBLIC HEALTH CARE FIXED COSTS PUBLIC HOSPITALS NURSES OBSERVATION TETANUS MARKETING MEDICAL CARE HOSPITAL PERSONNEL SYMPTOMS HEALTH ORGANIZATION SCREENING INTERVIEW MORTALITY GENERAL PRACTICE MEDICAL TREATMENT CANCER HIV TESTING MEDICAL EDUCATION EQUITY WORKERS HIV CARE HEALTH POLICY MEDICINE HEALTH OUTCOMES DEMAND DIARRHEA HYGIENE OLDER CHILDREN MEDICAL PERSONNEL HEALTH CLINICS CLINICAL PRACTICE MEASUREMENT NUTRITION MEDICAL OFFICER ADOLESCENTS PRIMARY HEALTH CARE PNEUMONIA HEALTH RESULTS INSURANCE WEIGHT PHYSICIANS PREGNANT WOMEN OBESITY EXERCISE CHILDREN CLINICAL TRIALS DISEASE CLINICS EVALUATION LOW BIRTH WEIGHT ILLNESS WELLNESS GENERAL PRACTITIONERS ADDICTION INFECTIONS COUNSELING ALL REHABILITATION POPULATION MATERNAL AND CHILD HEALTH WEIGHT LOSS SMOKING CESSATION NEWBORN HEALTH FEES EPIDEMIOLOGY CHILD HEALTH SERVICES VACCINE HOSPITALS MEDICAID HEALTH PROGRAMS HEALTH SERVICES IMPLEMENTATION PREGNANCY MEDICAL SCHOOLS
spellingShingle	PREMATURE BIRTH PHARMACY CHILD HEALTH BIRTH RISKS TREATMENT PERSONALITY PHYSICIAN FINANCING PHARMACISTS ANTENATAL CARE INCOME QUALITY OF HEALTH CARE PSYCHOLOGY PREVENTION DOCTORS HEALTH ECONOMICS MORBIDITY COMMUNITY HEALTH PRIMARY CARE PEDIATRICS HEALTH INSURANCE PRENATAL CARE HEALTH CARE MEDICAL RECORDS PREVENTIVE MEDICINE BIRTH CONTROL EFFECTS HEALTH CARE FACILITIES INCENTIVES SLEEP HEALTH HEALTH PROFESSIONALS HEALTH WORKERS SMOKERS HYPERTENSION HEALTH FACILITIES PUBLIC HEALTH HEALTH CONDITIONS QUALITY OF HEALTH RANDOMIZED CONTROLLED TRIALS ANEMIA HEALTH SECTOR KNOWLEDGE CHOICE DIABETES PREGNANT WOMAN HEALTH TARGETS PAIN WORKPLACE COSTS MEDICAL SCIENCE PILL LIFE PATIENT PATIENTS HOSPITAL RECORDS SMOKING INTERVENTION BIRTH WEIGHT PROBABILITY SEROLOGY PUBLIC HEALTH CARE FIXED COSTS PUBLIC HOSPITALS NURSES OBSERVATION TETANUS MARKETING MEDICAL CARE HOSPITAL PERSONNEL SYMPTOMS HEALTH ORGANIZATION SCREENING INTERVIEW MORTALITY GENERAL PRACTICE MEDICAL TREATMENT CANCER HIV TESTING MEDICAL EDUCATION EQUITY WORKERS HIV CARE HEALTH POLICY MEDICINE HEALTH OUTCOMES DEMAND DIARRHEA HYGIENE OLDER CHILDREN MEDICAL PERSONNEL HEALTH CLINICS CLINICAL PRACTICE MEASUREMENT NUTRITION MEDICAL OFFICER ADOLESCENTS PRIMARY HEALTH CARE PNEUMONIA HEALTH RESULTS INSURANCE WEIGHT PHYSICIANS PREGNANT WOMEN OBESITY EXERCISE CHILDREN CLINICAL TRIALS DISEASE CLINICS EVALUATION LOW BIRTH WEIGHT ILLNESS WELLNESS GENERAL PRACTITIONERS ADDICTION INFECTIONS COUNSELING ALL REHABILITATION POPULATION MATERNAL AND CHILD HEALTH WEIGHT LOSS SMOKING CESSATION NEWBORN HEALTH FEES EPIDEMIOLOGY CHILD HEALTH SERVICES VACCINE HOSPITALS MEDICAID HEALTH PROGRAMS HEALTH SERVICES IMPLEMENTATION PREGNANCY MEDICAL SCHOOLS Celhay, Pablo Gertler, Paul Giovagnoli, Paula Vermeersch, Christel Long-Run Effects of Temporary Incentives on Medical Care Productivity
relation	Policy Research Working Paper;No. 7348
description	The adoption of new clinical practice patterns by medical care providers is often challenging, even when the patterns are believed to be efficacious and profitable. This paper uses a randomized field experiment to examine the effects of temporary financial incentives paid to medical care clinics for the initiation of prenatal care in the first trimester of pregnancy. The rate of early initiation of prenatal care was 34 percent higher in the treatment group than in the control group while the incentives were being paid, and this effect persisted at least 15 months and likely 24 months or more after the incentives ended. These results are consistent with a model where the incentives enable providers to address the fixed costs of overcoming organizational inertia in innovation, and suggest that temporary incentives may be effective at motivating improvements in long-run provider performance at a substantially lower cost than permanent incentives.
format	Working Paper
author	Celhay, Pablo Gertler, Paul Giovagnoli, Paula Vermeersch, Christel
author_facet	Celhay, Pablo Gertler, Paul Giovagnoli, Paula Vermeersch, Christel
author_sort	Celhay, Pablo
title	Long-Run Effects of Temporary Incentives on Medical Care Productivity
title_short	Long-Run Effects of Temporary Incentives on Medical Care Productivity
title_full	Long-Run Effects of Temporary Incentives on Medical Care Productivity
title_fullStr	Long-Run Effects of Temporary Incentives on Medical Care Productivity
title_full_unstemmed	Long-Run Effects of Temporary Incentives on Medical Care Productivity
title_sort	long-run effects of temporary incentives on medical care productivity
publisher	World Bank, Washington, DC
publishDate	2015
url	http://documents.worldbank.org/curated/en/2015/06/24736285/long-run-effects-temporary-incentives-medical-care-productivity http://hdl.handle.net/10986/22228
_version_	1764450480786767872

Long-Run Effects of Temporary Incentives on Medical Care Productivity

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