IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v338y2023ics0277953623006883.html
   My bibliography  Save this article

Time's ticking! Effects of deadline on the utilization of health services: Evidence from a cluster-randomized controlled trial

Author

Listed:
  • Guan, Hongyu
  • Yang, Tianli
  • Zhang, Yunyun
  • Shi, Yaojiang

Abstract

The low utilization of health services in rural areas is an essential factor affecting the health level of rural residents. Based on insights from behavioral economics, this study evaluates the average treatment effect of imposing a deadline on vision-care vouchers (i.e., the voucher-deadline intervention) on the utilization of health services. Using the vision health as a case study, a non-masked cluster-randomized controlled trial was conducted in 13 rural schools of a county in Shaanxi Province of China during 2018–2019. Among 1270 baseline sample students with myopia, 610 students from 6 schools were randomly assigned to receive vouchers with no deadline (i.e., the Control group), and 660 students from 7 schools to receive vouchers with a 30-day deadline (i.e., the Deadline group). The results showed that the voucher-deadline intervention significantly improved the vision-center visiting rate by 13.2 percentage points within 30 days and shortened the interval between visits (i.e., increased timeliness) by 18.7 days. In comparison, the vision-center visiting rate and the interval between visits among the control group were 16.7% and 30.5 days, respectively. However, considering a longer time frame (6 months), we found that intervention only shifted students' utilization to before the voucher expires without improving overall utilization rate. The loss aversion and time pressure induced by the voucher deadline are possible explanations for the treatment effects. This study suggests insights from behavioral economics can enhance the design of public health programs to improve the utilization and the cost-effectiveness of health-service programs.

Suggested Citation

  • Guan, Hongyu & Yang, Tianli & Zhang, Yunyun & Shi, Yaojiang, 2023. "Time's ticking! Effects of deadline on the utilization of health services: Evidence from a cluster-randomized controlled trial," Social Science & Medicine, Elsevier, vol. 338(C).
    • Handle: RePEc:eee:socmed:v:338:y:2023:i:c:s0277953623006883
    DOI: 10.1016/j.socscimed.2023.116331
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953623006883
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2023.116331?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Seema Kacker & Mario Macis & Prateek Gajwani & David S. Friedman, 2022. "Providing vouchers and value information for already free eye exams increases uptake among a low‐income minority population: A randomized trial," Health Economics, John Wiley & Sons, Ltd., vol. 31(3), pages 541-551, March.
    2. Janet Currie, 2004. "The Take Up of Social Benefits," NBER Working Papers 10488, National Bureau of Economic Research, Inc.
    3. Inman, J Jeffrey & Peter, Anil C & Raghubir, Priya, 1997. "Framing the Deal: The Role of Restrictions in Accentuating Deal Value," Journal of Consumer Research, Journal of Consumer Research Inc., vol. 24(1), pages 68-79, June.
    4. Manasi Deshpande & Yue Li, 2019. "Who Is Screened Out? Application Costs and the Targeting of Disability Programs," American Economic Journal: Economic Policy, American Economic Association, vol. 11(4), pages 213-248, November.
    5. Emir Kamenica, 2012. "Behavioral Economics and Psychology of Incentives," Annual Review of Economics, Annual Reviews, vol. 4(1), pages 427-452, July.
    6. Aradhna Krishna & Z. John Zhang, 1999. "Short- or Long-Duration Coupons: The Effect of the Expiration Date on the Profitability of Coupon Promotions," Management Science, INFORMS, vol. 45(8), pages 1041-1056, August.
    7. Amy Finkelstein & Matthew J Notowidigdo, 2019. "Take-Up and Targeting: Experimental Evidence from SNAP," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(3), pages 1505-1556.
    8. Daniel Kahneman & Amos Tversky, 2013. "Prospect Theory: An Analysis of Decision Under Risk," World Scientific Book Chapters, in: Leonard C MacLean & William T Ziemba (ed.), HANDBOOK OF THE FUNDAMENTALS OF FINANCIAL DECISION MAKING Part I, chapter 6, pages 99-127, World Scientific Publishing Co. Pte. Ltd..
    9. Saurabh Bhargava & Dayanand Manoli, 2015. "Psychological Frictions and the Incomplete Take-Up of Social Benefits: Evidence from an IRS Field Experiment," American Economic Review, American Economic Association, vol. 105(11), pages 3489-3529, November.
    10. Yi, Hongmei & Zhang, Linxiu & Ma, Xiaochen & Congdon, Nathan & Shi, Yaojiang & Pang, Xiaopeng & Zeng, Junxia & Wang, Lei & Boswell, Matthew & Rozelle, Scott, 2015. "Poor vision among China's rural primary school students: Prevalence, correlates and consequences," China Economic Review, Elsevier, vol. 33(C), pages 247-262.
    11. Ordonez, Lisa & Benson, Lehman, 1997. "Decisions under Time Pressure: How Time Constraint Affects Risky Decision Making," Organizational Behavior and Human Decision Processes, Elsevier, vol. 71(2), pages 121-140, August.
    12. Jiwoong Shin & Dan Ariely, 2004. "Keeping Doors Open: The Effect of Unavailability on Incentives to Keep Options Viable," Management Science, INFORMS, vol. 50(5), pages 575-586, May.
    13. Jessica Cohen & Pascaline Dupas, 2010. "Free Distribution or Cost-Sharing? Evidence from a Randomized Malaria Prevention Experiment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(1), pages 1-45.
    14. Anca M. Grecu & Ghanshyam Sharma, 2019. "The effect of telehealth insurance mandates on health-care utilization and outcomes," Applied Economics, Taylor & Francis Journals, vol. 51(56), pages 5972-5985, December.
    15. Cass Sunstein, 2014. "Nudging: A Very Short Guide," Journal of Consumer Policy, Springer, vol. 37(4), pages 583-588, December.
    16. Essl, Andrea & Jaussi, Stefanie, 2017. "Choking under time pressure: The influence of deadline-dependent bonus and malus incentive schemes on performance," Journal of Economic Behavior & Organization, Elsevier, vol. 133(C), pages 127-137.
    17. Sylvia, Sean & Ma, Xiaochen & Shi, Yaojiang & Rozelle, Scott, 2022. "Ordeal mechanisms, information, and the cost-effectiveness of strategies to provide subsidized eyeglasses," Journal of Health Economics, Elsevier, vol. 82(C).
    18. Abhijit Banerjee & Amy Finkelstein & Rema Hanna & Benjamin A. Olken & Arianna Ornaghi & Sudarno Sumarto, 2021. "The Challenges of Universal Health Insurance in Developing Countries: Experimental Evidence from Indonesia's National Health Insurance," American Economic Review, American Economic Association, vol. 111(9), pages 3035-3063, September.
    19. Eric P. Bettinger & Bridget Terry Long & Philip Oreopoulos & Lisa Sanbonmatsu, 2012. "The Role of Application Assistance and Information in College Decisions: Results from the H&R Block Fafsa Experiment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1205-1242.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tatiana Homonoff & Jason Somerville, 2021. "Program Recertification Costs: Evidence from SNAP," American Economic Journal: Economic Policy, American Economic Association, vol. 13(4), pages 271-298, November.
    2. Ha Trong Nguyen & Huong Thu Le & Luke B Connelly, 2021. "Who's declining the “free lunch”? New evidence from the uptake of public child dental benefits," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 270-288, February.
    3. Alejandro Cid & José María Cabrera & Marianne Bernatzky & María Ramírez-Michelena & Magdalena Blanco, 2019. "Strategies to increase the take-up of social benefits. Evidence from a field experiment in a deeply vulnerable population," Documentos de Trabajo/Working Papers 1908, Facultad de Ciencias Empresariales y Economia. Universidad de Montevideo..
    4. Laura Castell & Marc Gurgand & Clément Imbert & Todor Tochev, 2024. "Take-up of Social Benefits: Experimental Evidence from France," PSE Working Papers halshs-04720989, HAL.
    5. Robert W. Hahn & Robert D. Metcalfe, 2021. "Efficiency and Equity Impacts of Energy Subsidies," American Economic Review, American Economic Association, vol. 111(5), pages 1658-1688, May.
    6. Leonard M. Lopoo & Colleen Heflin & Boskovski, 2020. "Testing behavioral interventions designed to improve on-time SNAP recertification," Journal of Behavioral Public Administration, Center for Experimental and Behavioral Public Administration, vol. 3(2).
    7. Heather Klemick & Ann Wolverton & Bryan Parthum & Kristin Epstein & Sandra Kutzing & Sarah Armstrong, 2024. "Factors Influencing Customer Participation in a Program to Replace Lead Pipes for Drinking Water," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 87(3), pages 791-832, March.
    8. Narayan, Ayushi, 2020. "Does simplifying the college financial aid process matter?," Economics of Education Review, Elsevier, vol. 75(C).
    9. Wu, Derek & Meyer, Bruce D., 2023. "Certification and Recertification in Welfare Programs: What Happens When Automation Goes Wrong?," IZA Discussion Papers 16294, Institute of Labor Economics (IZA).
    10. Tincani, Michela M. & Kosse, Fabian & Miglino, Enrico, 2022. "The Effect of Preferential Admissions on the College Participation of Disadvantaged Students: The Role of Pre-College Choices," IZA Discussion Papers 15633, Institute of Labor Economics (IZA).
    11. Michela Maria Tincani & Fabian Kosse & Enrico Miglino, 2022. "The Effect of Preferential Admissions on the College Participation of Disadvantaged Students: The Role of Pre-College Choices," CESifo Working Paper Series 10020, CESifo.
    12. Manasi Deshpande & Yue Li, 2019. "Who Is Screened Out? Application Costs and the Targeting of Disability Programs," American Economic Journal: Economic Policy, American Economic Association, vol. 11(4), pages 213-248, November.
    13. Rosenqvist, Olof & Selin, Håkan, 2023. "Explaining benefit take-up behavior – the role of incentives and habits," Working Paper Series 2023:24, IFAU - Institute for Evaluation of Labour Market and Education Policy.
    14. Brigitte C. Madrian, 2014. "Applying Insights from Behavioral Economics to Policy Design," Annual Review of Economics, Annual Reviews, vol. 6(1), pages 663-688, August.
    15. Anderson, Drew M. & Goldrick-Rab, Sara, 2018. "Aid after enrollment: Impacts of a statewide grant program at public two-year colleges," Economics of Education Review, Elsevier, vol. 67(C), pages 148-157.
    16. Olof Rosenqvist & Håkan Selin, 2024. "Explaining Benefit Take-up Behavior – The Role of Financial Incentives," CESifo Working Paper Series 11402, CESifo.
    17. Andrieş, Alin Marius & Walker, Sarah, 2023. "When the message hurts: The unintended impacts of nudges on saving," Journal of Comparative Economics, Elsevier, vol. 51(2), pages 439-456.
    18. Julie Janssens & Natascha Van Mechelen, 2017. "Who is to Blame? An Overview of the Factors Contributing to the Non-Take-Up of Social Rights," Working Papers 1708, Herman Deleeck Centre for Social Policy, University of Antwerp.
    19. Goldin, Jacob & Homonoff, Tatiana & Javaid, Rizwan & Schafer, Brenda, 2022. "Tax filing and take-up: Experimental evidence on tax preparation outreach and benefit claiming," Journal of Public Economics, Elsevier, vol. 206(C).
    20. Humphries, John Eric & Neilson, Christopher A. & Ulyssea, Gabriel, 2020. "Information frictions and access to the Paycheck Protection Program," Journal of Public Economics, Elsevier, vol. 190(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:338:y:2023:i:c:s0277953623006883. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.