Unpacking Accountability: Evidence from Hospital Waiting Times

Last registered on July 19, 2023
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Pre-Trial

Trial Information

General Information

Title
Unpacking Accountability: Evidence from Hospital Waiting Times
RCT ID
AEARCTR-0011740
Initial registration date
July 07, 2023

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
July 19, 2023, 11:56 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Country
Spain
Region

Primary Investigator

Name
SILVIA VANNUTELLI
Affiliation
Northwestern university
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Other Primary Investigator(s)

PI Name
Monica Martinez-Bravo
PI Affiliation
CEMFI
Contact Investigator
PI Name
Carlos Sanz
PI Affiliation
Banco de España
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Additional Trial Information

Status
In development
Start date
2023-07-07
End date
2024-03-01
Keywords
Governance, Health
Additional Keywords
JEL code(s)
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
In this study, we analyze the political and economic consequences of providing information about waiting times in healthcare. With this objective, we plan to implement a number of large-scale online experiments conducted on a representative sample of the Spanish population. Spain was one of the most severely affected countries by the Covid-19 pandemic, which critically impacted access to healthcare for non-urgent visits and procedures, leading to a substantial lengthening in waiting times for both specialist visits and elective surgeries.

Our main research question is to study how providing information about the waiting times for healthcare surgeries and consultations and about the difference in service provision across Spanish regions affect trust in institutions, support for extremist parties, polarization, and distributive preferences, among other political attitudes.
External Link(s)

Registration Citation

Citation
Martinez-Bravo, Monica, Carlos Sanz and SILVIA VANNUTELLI. 2023. "Unpacking Accountability: Evidence from Hospital Waiting Times." AEA RCT Registry. July 19. https://doi.org/10.1257/rct.11740-1.0
Sponsors & Partners
Experimental Details

Interventions

Intervention(s)
Intervention Start Date
2023-07-07
Intervention End Date
2023-07-21

Primary Outcomes

Primary Outcomes (end points)
o Beliefs.
o Trust in political institutions.
o Assessment of the performance of the current national and regional government in managing healthcare
o Political preferences and polarization. Ideological and Affective polarization.
o Support for Taxation and Redistribution.
o Self-assessment of emotional well-being.
o (See the attached pre-analysis plan for details.)
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
Individuals will be randomly assigned to one of the following groups:

T1: This group obtains a treatment that consists on information on the waiting time for healthcare services in his/her region. First, we elicit the individual's prior on what is the waiting time for healthcare services in his/her region (Autonomous Communities in Spain) and his/her preferences regarding optimal waiting time. We also obtain his/her priors regarding how the waiting time in their region compares to the rest of Spanish regions. Second, we provide the actual waiting time in the region based on the latest data available from the Ministry of Healthcare for 2022. This group is split into two sub-groups:
T1a. is asked about priors and provided information about waiting times for specialists’ consultation.
T1b. is asked about priors and provided information about waiting times for elective surgery procedures.

T2: This group obtains the same information and prior elicitation as those in T1. At the end of that treatment, they receive additional information on how the waiting time in their region compares to the rest of Spanish regions. As before, the group is split into two subgroups:
T2a. is asked about priors and provided information about waiting times for specialists’ consultation.
T2b. is asked about priors and provided information about waiting times for elective surgery procedures.

Control: This group does not receive any treatment. We elicit the priors regarding waiting times for both specialist consultations and elective surgery procedures and the respective comparison across regions, and preferences regarding optimal waiting time, but then we do not provide any information about the actual waiting times.


Randomization:
The sample is randomized to the three groups according to the following proportions: T1 (1/3 of the sample, then split equally among T1a and T1b), T2 (1/3 of the sample, then split equally among T2a and T2b), Control (1/3 of the sample).

The randomization is stratified by region, age, education level, and ideological alignment in the left-right axis. In particular, the combination of each of the 17 Autonomous Communities of Spain, 3 age-levels, 2 education groups, and 2 regional alignment categories define different strata. Individuals in each stratum are randomly assigned to the five groups (treatments T1a, T1b, T2a, T2b and control) without replacement.
Experimental Design Details
Randomization Method
Randomization done by survey company's computer.
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
NA
Sample size: planned number of observations
4,200 (in expectation)
Sample size (or number of clusters) by treatment arms
700 in treatment T1A, 700 in treatment T1B, 700 in treatment T2A, 700 in treatment T2B, 1400 in control group
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Ethics Committee of CEMFI
IRB Approval Date
2023-06-18
IRB Approval Number
N/A
Analysis Plan

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Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials