Discrimination and Health Care: The Case of Dentistry Appointments

Last registered on January 15, 2025

Pre-Trial

Trial Information

General Information

Title
Discrimination and Health Care: The Case of Dentistry Appointments
RCT ID
AEARCTR-0015149
Initial registration date
January 10, 2025

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
January 15, 2025, 5:21 AM EST

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

Locations

Region

Primary Investigator

Affiliation
Hamilton College

Other Primary Investigator(s)

PI Affiliation
Hamilton College
PI Affiliation
Hamilton College

Additional Trial Information

Status
In development
Start date
2025-03-01
End date
2026-04-01
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
This project tests for the presence of discrimination in access to health care by conducting an audit study of approximately 4,000 dental care providers from across the United States. We will use fictitious profiles of patients attempting to obtain appointments through online portals to record and analyze response rates and timing of responses. Profiles of applicants will be randomized along several dimensions: implied race/ethnicity, difficulty of name pronunciation, insurance status, and implied socioeconomic status.
External Link(s)

Registration Citation

Citation
Cross, Jeffrey, Evelyn Skoy and Stephen Wu. 2025. "Discrimination and Health Care: The Case of Dentistry Appointments." AEA RCT Registry. January 15. https://doi.org/10.1257/rct.15149-1.0
Experimental Details

Interventions

Intervention(s)
From the pool of dental providers that utilize a standard appointment request form, we draw a simple random sample across the United States to obtain approximately 4,000 providers across the country to request a first-time appointment for a fictitious patient. One potential concern is that providers, particularly ones in less populated locations, where there will be fewer new potential patients, may get suspicious if there is a significant increase in requests within a short span of time. To minimize this concern, we request first-time appointments once every two months over the period of a year, giving us 24,000 observations (4,000*6).
Intervention Start Date
2025-03-01
Intervention End Date
2026-04-01

Primary Outcomes

Primary Outcomes (end points)
Response within 30 days (yes or no); timing of response
Primary Outcomes (explanation)
Our primary outcome will be whether or not a dental office responds (via e-mail and/or phone) to an applicant’s request for an initial appointment as a new patient. From a small pilot, we know almost all responses come within one week, so allowing for 30 days should be sufficient. We will also test to see if there are differences in whether the provider indicates that they are taking on new patients and how quickly a provider responds (measured in business days).

Secondary Outcomes

Secondary Outcomes (end points)
Heterogeneous effects by county characteristics (rural vs urban, racial diversity, political composition), dental practice characteristics (size of practice, racial and gender composition of practice), and difficulty of name pronunciation
Secondary Outcomes (explanation)
We will test to see whether the degree of discrimination varies along a number of dimensions. Racial/ethnic and name-based discrimination may be more likely to occur in locations with fewer non-whites and in areas of the country and in dental practices that are less diverse.

Experimental Design

Experimental Design
We will be using both email addresses and phone numbers to collect data.

Instruments will be created for each persona that is developed so that we minimize the risk of repeating email addresses and phone numbers submitted to the dental practices. All emails will be forwarded to a central email account for ease of data collection. For phones, a separate Google phone number will be set up for each wave of applications and messages will be monitored and recorded by research assistants. Both instruments (phone and email) are standard methods that dental providers use to respond to appointment inquiries and they will allow us to track response dates and times along with the content of the response.
Experimental Design Details
Not available
Randomization Method
Randomization done in the office by a computer
Randomization Unit
Individual
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
4,000
Sample size: planned number of observations
24,000
Sample size (or number of clusters) by treatment arms
1,333
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
Hamilton College Institutional Review Board
IRB Approval Date
2023-07-20
IRB Approval Number
N/A
Analysis Plan

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