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Do Patients Value High-Quality Medical Care? Experimental Evidence from Malaria Diagnosis and Treatment

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  • Carolina Lopez
  • Anja Sautmann
  • Simone G. Schaner

Abstract

Can better information on the value of diagnostic tests improve adoption and help patients recognize higher quality of care? In a randomized experiment in public clinics in Mali, providers and patients received tailored information about the importance of rapid diagnostic tests (RDT) for malaria. The provider training increased reliance on RDTs and improved the match between a patient’s malaria status and treatment with antimalarials by 15-30 percent. Nonetheless, patients were significantly less satisfied with the care they received, driven by those whose prior beliefs did not match their malaria status. The patient information intervention reduced malaria testing and did not improve treatment outcomes or patient satisfaction. These findings are consistent with highly persistent patient beliefs and distrust of the promoted diagnostic technology, which translate into low demand and limit patients’ ability to recognize improved quality of care.

Suggested Citation

  • Carolina Lopez & Anja Sautmann & Simone G. Schaner, 2024. "Do Patients Value High-Quality Medical Care? Experimental Evidence from Malaria Diagnosis and Treatment," NBER Working Papers 32075, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:32075
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    1. Clément de Chaisemartin & Jaime Ramirez-Cuellar, 2024. "At What Level Should One Cluster Standard Errors in Paired and Small-Strata Experiments?," American Economic Journal: Applied Economics, American Economic Association, vol. 16(1), pages 193-212, January.
    2. Busfield, Joan, 2015. "Assessing the overuse of medicines," Social Science & Medicine, Elsevier, vol. 131(C), pages 199-206.
    3. Jeffrey R Kling & Jeffrey B Liebman & Lawrence F Katz, 2007. "Experimental Analysis of Neighborhood Effects," Econometrica, Econometric Society, vol. 75(1), pages 83-119, January.
    4. Amitabh Chandra & Amy Finkelstein & Adam Sacarny & Chad Syverson, 2016. "Health Care Exceptionalism? Performance and Allocation in the US Health Care Sector," American Economic Review, American Economic Association, vol. 106(8), pages 2110-2144, August.
    5. Carolina Lopez & Anja Sautmann & Simone Schaner, 2022. "Does Patient Demand Contribute to the Overuse of Prescription Drugs?," American Economic Journal: Applied Economics, American Economic Association, vol. 14(1), pages 225-260, January.
    6. Alexandre Belloni & Victor Chernozhukov & Christian Hansen, 2014. "High-Dimensional Methods and Inference on Structural and Treatment Effects," Journal of Economic Perspectives, American Economic Association, vol. 28(2), pages 29-50, Spring.
    7. Jishnu Das & Jeffrey Hammer & Kenneth Leonard, 2008. "The Quality of Medical Advice in Low-Income Countries," Journal of Economic Perspectives, American Economic Association, vol. 22(2), pages 93-114, Spring.
    8. Jishnu Das & Alaka Holla & Aakash Mohpal & Karthik Muralidharan, 2016. "Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India," American Economic Review, American Economic Association, vol. 106(12), pages 3765-3799, December.
    9. Jessica Cohen & Pascaline Dupas & Simone Schaner, 2015. "Price Subsidies, Diagnostic Tests, and Targeting of Malaria Treatment: Evidence from a Randomized Controlled Trial," American Economic Review, American Economic Association, vol. 105(2), pages 609-645, February.
    10. Currie, Janet & Lin, Wanchuan & Meng, Juanjuan, 2014. "Addressing antibiotic abuse in China: An experimental audit study," Journal of Development Economics, Elsevier, vol. 110(C), pages 39-51.
    11. Lagarde, Mylène & Blaauw, Duane, 2022. "Overtreatment and benevolent provider moral hazard: Evidence from South African doctors," Journal of Development Economics, Elsevier, vol. 158(C).
    12. Lagarde, Mylène & Blaauw, Duane, 2022. "Overtreatment and benevolent provider moral hazard: evidence from South African doctors," LSE Research Online Documents on Economics 115383, London School of Economics and Political Science, LSE Library.
    13. Achyuta Adhvaryu, 2014. "Learning, Misallocation, and Technology Adoption: Evidence from New Malaria Therapy in Tanzania," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 81(4), pages 1331-1365.
    14. Toshiaki Iizuka, 2012. "Physician Agency and Adoption of Generic Pharmaceuticals," American Economic Review, American Economic Association, vol. 102(6), pages 2826-2858, October.
    15. Jishnu Das & Jeffrey Hammer, 2014. "Quality of Primary Care in Low-Income Countries: Facts and Economics," Annual Review of Economics, Annual Reviews, vol. 6(1), pages 525-553, August.
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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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