Abstract
In 2008, the Japanese government launched a new health checkup system, the Specified Health Examination. The purpose of this checkup is to screen pre-diabetic patients who are at risk of developing cardiovascular diseases and diabetes mellitus, and to provide early intervention for receiving medical treatment and improving lifestyle. The uptake rate in FY2020 was 53.4%, compared to the government’s target of 70%. The uptake rate for National Health Insurance subscribers, which includes self-employed people, was only 33.7%.
Based on behavioral economics findings, this study aims to develop reminder postcards to encourage National Health Insurance subscribers to take the specific health examination and to clarify how these interventions affect the uptake behavior experimentally. Specifically, in this study, we collaborate with a local government in the Kansai region and conduct a field experiment for their citizens. We set up interventions to devise the content of reminder postcards and another intervention to increase the number of times reminder postcards are mailed. We estimate these interventions' effects and compare them with each other. In addition, we examine how the effects depend on the subjects' past experiences of receiving the checkups and other factors.
The subjects of this experiment (around 48,000 citizens) are the National Health Insurance subscribers in the age group eligible for the Specified Health Examination in FY2022. In addition, they have not received the checkups by the time the postcards are mailed. We randomly assign them to four groups at the individual level. In the treatment groups, we change the content of the reminder postcard and the number of mailings as follows:
- Control group: We mail a postcard explaining the necessity of the specific health examination and how to make an appointment.
- Treatment group 1: We add the message "Do you still have your free voucher for the specific health examination?" to the control group's postcard and then introduce a simple way to reissue the voucher.
- Treatment group 2: We add the message "Do you believe that you do not need to take the specific health examination this year?" to the control group's postcard and then explain the importance of continuously receiving health checkups.
- Treatment group 3: We mail the control group's postcard twice.
We will send the postcards in late October 2022. In treatment group 3, we will send the second mailing in late January 2023. The outcome variables are the presence or absence and timing of the health checkup from the first mailing time to the end of March 2023.