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Increasing the take-up of public health services: An at-scale experiment on digital government

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  • Gallegos, Sebastian
  • Roseth, Benjamin
  • Cuesta, Ana
  • Sánchez, Mario

Abstract

Increasing public service take-up is a critical challenge. We invested in a government-run digital appointment system for an important health screening service and conducted a large-scale experiment encouraging its use, specifically assessing the influence of transactions costs and information. Using administrative records on the near-universe of eligible women (47,600) in Uruguay’s capital city, we randomized invitations to book with our digital-system or as-usual with local clinics. Digital encouragements doubled medical visits versus as-usual invitations, and tripled compared to a pure control group (5.5 % versus 1.9 %) over 16 weeks. These large impacts are highly cost-effective, mediated by salience and reduced transactions costs.

Suggested Citation

  • Gallegos, Sebastian & Roseth, Benjamin & Cuesta, Ana & Sánchez, Mario, 2023. "Increasing the take-up of public health services: An at-scale experiment on digital government," Journal of Public Economics, Elsevier, vol. 227(C).
    • Handle: RePEc:eee:pubeco:v:227:y:2023:i:c:s0047272723001573
    DOI: 10.1016/j.jpubeco.2023.104975
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    More about this item

    Keywords

    State capacity; Digital government; Health behaviors; Administrative barriers; Red tape; Public healthcare; Women; Behavioral economics; Transaction costs; Economic development;
    All these keywords.

    JEL classification:

    • O10 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - General
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes
    • D73 - Microeconomics - - Analysis of Collective Decision-Making - - - Bureaucracy; Administrative Processes in Public Organizations; Corruption
    • D91 - Microeconomics - - Micro-Based Behavioral Economics - - - Role and Effects of Psychological, Emotional, Social, and Cognitive Factors on Decision Making
    • H53 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Welfare Programs
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development

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