Working Paper: NBER ID: w21361
Authors: Pablo Celhay; Paul Gertler; Paula Giovagnoli; Christel Vermeersch
Abstract: The adoption of new clinical practice patterns by medical care providers is often challenging, even when they are believed to be both 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% higher in the treatment group than in the control group while the incentives were being paid, and this effect persisted at least 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.
Keywords: temporary financial incentives; prenatal care; randomized field experiment; health care productivity
JEL Codes: I11; I13; I15
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Early initiation of prenatal care (J13) | Changes in clinic behavior (C92) |
| Temporary financial incentives (J33) | Overcoming organizational inertia (L29) |
| Temporary financial incentives (J33) | Lasting changes in practice patterns (I11) |
| Early initiation of prenatal care (J13) | Birth outcomes (J13) |
| Temporary financial incentives (J33) | Early initiation of prenatal care (J13) |