AEA RC T Registr y

The American Economic Association's registry for randomized controlled trials

We are conducting a phone-based experiment to test whether information about the health insurance scheme can help patients hold hospitals accountable and reduce cash outlays. If effective, this will confirm that hospitals are exploiting patient lack of information, provide insights into the role information plays in these markets, and demonstrate that information can empower patients to hold hospitals accountable.

The exact information provided is as follows:
Verbal at end of phone survey:
"I would like to give you information about the Government of XXX [SCHEME NAME]. The program covers the full costs of dialysis, including hospital care, tests, and medicines. You and your household are eligible. You just need to show your XX card number. All public hospitals and many private hospitals are included in the program. [ClaimHosp], where you have gone for dialysis before, is included. The hospital receives between 1500 and 2000 rupees from the [SCHEME NAME] for each of your dialysis visits. These are the names of other hospitals that are within 10 kilometers of that hospital, and that are also included in the SCHEME: NbrHosp1, NbrHosp2, NbrHosp3. Dialysis and related tests and medicines should be free under [SCHEME NAME] at all these places.”

By SMS following the survey:
"Under [SCHEME NAME] your dialysis, tests, and medicines should be free. The hospital receives between 1500 and 2000 rupees from the Yojana for each of your dialysis visits. These hospitals close to you do dialysis and are included in the SCHEME: ClaimHosp, NbrHosp1, NbrHosp2, NbrHosp3”

2018-03-29

2018-05-31

From survey data: Knowledge of the scheme's benefits, negotiating with the hospital, switching to other hospitals, cash paid
From administrative data: hospital switching

Quality of care received

The experiment focuses on dialysis patients because they visit a facility repeatedly (so information may affect subsequent visits) and because dialysis is a relatively standardized service. Dialysis patients identified as having received dialysis care in a participating hospital in the recent past as per the administrative claims data were stratified by hospital and randomly assigned to three groups.

T1 Group: Patients receive detailed information about the program, their benefits, and names of participating hospitals, at the end of a baseline survey. Information is first provided verbally at the end of the phone survey, and is also sent to the respondent as an SMS. This group will be surveyed again for a midline 4 weeks later. At that time the information will be repeated to them. They will be surveyed again for an endline 8 weeks later.

T2 Group: These patients will be surveyed twice, at midline and endline. They will receive the detailed BSBY information at the end of the midline survey. They will receive the information only once.

Control group: only surveyed at endline.

The T1 group baseline, T2 group middline and Control endline surveys are the same and will allow us to check that the randomization successfully ensured that time invariant characteristics between the groups are similar on average. The T1 and T2 Group endline survey is almost the same but simply excludes questions about time-invariant characteristics that were already asked at baseline/midline; we will compare the endline survey data and the administrative data across the three groups to assess any difference in outcomes between patients that received the information treatment once or twice or not at all. We will compare the midline outcomes between T1 and T2, as well as the endline outcomes between Control and T2, to estimate the impact of receiving the information once.
We will look at heterogeneity by the density of hospitals in the area, since the ability to bargain with a hospital is likely a function of outside options available.

Randomization done in office by a computer

Individual

No

1185

1185

T1: 449
T2: 434
Control: 302