Encouraging Preventative Care to Manage Chronic Disease at Scale / Claire E. Boone, Pablo A. Celhay, Paul Gertler, Tadeja Gracner.

Format:

Book

Author/Creator:

Boone, Claire E.

Contributor:

National Bureau of Economic Research.

Celhay, Pablo A.

Gertler, Paul.

Gracner, Tadeja.

Series:

Working Paper Series (National Bureau of Economic Research) no. w31643.

NBER working paper series no. w31643

Language:

English

Physical Description:

1 online resource: illustrations (black and white);

Place of Publication:

Cambridge, Mass. National Bureau of Economic Research 2023.

Summary:

We study how reminding high-risk patients with chronic disease of their upcoming primary care appointments impacts their health care and behaviors. We leverage a natural experiment in Chile's public healthcare system that sent reminders before preventative care appointments to over 300,000 patients with type 2 diabetes and hypertension across 315 public primary care clinics between 2013 and 2018. Employing both a difference-in-differences and instrumental variables approach on national administrative patient-level data, we show that reminders increased preventative care visits, which led to more health screenings and improved medication adherence. In this at-scale program, we find substantial variation in implementation fidelity across clinics, which, once accounted for increases our estimates by over a third. Reminders also increased hospitalizations and reduced in-hospital mortality, suggesting an improvement in timely care-seeking behavior among high-risk patients. Our findings inform healthcare settings where patients must first visit their primary care provider for approval before undergoing tests, receiving medication prescriptions, or getting referrals to other specialists. Through intervening at the first step in the cascade of care, we find that a simple intervention like reminders can have large and meaningful downstream effects.

Notes:

Print version record

August 2023.