Long-Run Effects of Temporary Incentives on Medical Care Productivity
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World Bank, Washington, DC
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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.
Palabras clave
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