IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v125y2021i2p254-260.html
   My bibliography  Save this article

Effect of Strict and Soft Policy Interventions on Laboratory Diagnostic Testing in Ontario, Canada: A Bayesian Structural Time Series Analysis

Author

Listed:
  • Chami, Nadine
  • Li, Yin
  • Weir, Sharada
  • Wright, James G.
  • Kantarevic, Jasmin

Abstract

Applications of behavioral economics targeted at optimizing laboratory utilization among physicians have been implemented in Ontario through different types of nonfinancial interventions. Strict policy interventions restrict Ontario Health Insurance Plan (OHIP) payment for tests to patients with specific conditions or limit ordering to particular physician specialties, while soft policy interventions involve modifications to the laboratory requisition form. This study evaluates the effectiveness of these interventions in terms of changing physician ordering behavior for eight tests that were subject to a strict or soft policy intervention during the study period. We use a Bayesian structural time series model applied to Ontario laboratory claims data for FY2006 through FY2017. Results show a 16–75% reduction in laboratory services with a strict policy intervention and an 8–36% reduction in laboratory services with a soft policy intervention. Although the overall magnitude of change was smaller for soft policy interventions, interventions designed with soft or strict policy mechanisms addressing laboratory utilization management are effective at influencing physicians’ test ordering behavior.

Suggested Citation

  • Chami, Nadine & Li, Yin & Weir, Sharada & Wright, James G. & Kantarevic, Jasmin, 2021. "Effect of Strict and Soft Policy Interventions on Laboratory Diagnostic Testing in Ontario, Canada: A Bayesian Structural Time Series Analysis," Health Policy, Elsevier, vol. 125(2), pages 254-260.
    • Handle: RePEc:eee:hepoli:v:125:y:2021:i:2:p:254-260
    DOI: 10.1016/j.healthpol.2020.10.007
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851020302621
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2020.10.007?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Richard H. Thaler & Cass R. Sunstein, 2023. "Libertarian paternalism," Chapters, in: Cass R. Sunstein & Lucia A. Reisch (ed.), Research Handbook on Nudges and Society, chapter 1, pages 10-16, Edward Elgar Publishing.
    2. Christopher Naugler & Rosalie Wyonch, 2019. "What the Doctor Ordered: Improving the Use and Value of Laboratory Testing," C.D. Howe Institute Commentary, C.D. Howe Institute, issue 533, February.
    3. Cass R. Sunstein & Richard H. Thaler, 2003. "Libertarian paternalism is not an oxymoron," Conference Series ; [Proceedings], Federal Reserve Bank of Boston, vol. 48(Jun).
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Joseph E. Stiglitz, 2017. "The overselling of globalization," Business Economics, Palgrave Macmillan;National Association for Business Economics, vol. 52(3), pages 129-137, July.
    2. Ross Guest, 2010. "Policy Forum: Saving for Retirement: Policy Options to Increase Retirement Saving in Australia," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 43(3), pages 293-301, September.
    3. Asen Ivanov, 2021. "Optimal pension plan default policies when employees are biased," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 23(3), pages 583-596, June.
    4. Schnellenbach, Jan, 2012. "Nudges and norms: On the political economy of soft paternalism," European Journal of Political Economy, Elsevier, vol. 28(2), pages 266-277.
    5. Ajla Cosic & Hana Cosic & Sebastian Ille, 2018. "Can nudges affect students' green behaviour? A field experiment," Journal of Behavioral Economics for Policy, Society for the Advancement of Behavioral Economics (SABE), vol. 2(1), pages 107-111, March.
    6. Till Grüne-Yanoff, 2012. "Old wine in new casks: libertarian paternalism still violates liberal principles," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 38(4), pages 635-645, April.
    7. Christopher Jeffords, 2014. "Preference-directed regulation when ethical environmental policy choices are formed with limited information," Empirical Economics, Springer, vol. 46(2), pages 573-606, March.
    8. Markus Haavio & Kaisa Kotakorpi, 2012. "Sin Licenses Revisited," CESifo Working Paper Series 4010, CESifo.
    9. Schnellenbach, Jan & Schubert, Christian, 2015. "Behavioral political economy: A survey," European Journal of Political Economy, Elsevier, vol. 40(PB), pages 395-417.
    10. Dohmen, Thomas & Falk, Armin & Huffman, David & Marklein, Felix & Sunde, Uwe, 2009. "Biased probability judgment: Evidence of incidence and relationship to economic outcomes from a representative sample," Journal of Economic Behavior & Organization, Elsevier, vol. 72(3), pages 903-915, December.
    11. Ashton, John K. & Hudson, Robert S., 2008. "Interest rate clustering in UK financial services markets," Journal of Banking & Finance, Elsevier, vol. 32(7), pages 1393-1403, July.
    12. Brown, Zachary & Johnstone, Nick & Haščič, Ivan & Vong, Laura & Barascud, Francis, 2013. "Testing the effect of defaults on the thermostat settings of OECD employees," Energy Economics, Elsevier, vol. 39(C), pages 128-134.
    13. Joshua Henkel & Georg Schwesinger, 2020. "Establishing Sustainable Consumption - How Future Policies Can Channel Consumer Preferences," Bremen Papers on Economics & Innovation 2007, University of Bremen, Faculty of Business Studies and Economics.
    14. Marc A. Ragin & Benjamin L. Collier & Johannes G. Jaspersen, 2021. "The effect of information disclosure on demand for high‐load insurance," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 88(1), pages 161-193, March.
    15. Daniel Schatz & Rabih Bashroush, 0. "Economic valuation for information security investment: a systematic literature review," Information Systems Frontiers, Springer, vol. 0, pages 1-24.
    16. Chakravarty, Sujoy & Mishra, Rajan, 2019. "Using social norms to reduce paper waste: Results from a field experiment in the Indian Information Technology sector," Ecological Economics, Elsevier, vol. 164(C), pages 1-1.
    17. Eiichi Tomiura & Banri Ito & Hiroshi Mukunoki & Ryuhei Wakasugi, 2016. "Individual Characteristics, Behavioral Biases, and Trade Policy Preferences: Evidence from a Survey in Japan," Review of International Economics, Wiley Blackwell, vol. 24(5), pages 1081-1095, November.
    18. Cecilia Rossel & Denise Courtoisie & Magdalena Marsiglia, 2019. "How could conditional cash transfer programme conditionalities reinforce vulnerability? Non‐compliers and policy implementation gaps in Uruguay's Family Allowances," Development Policy Review, Overseas Development Institute, vol. 37(1), pages 3-18, January.
    19. Geiger, Martin & Luhan, Wolfgang J. & Scharler, Johann, 2016. "When do fiscal consolidations lead to consumption booms? Lessons from a laboratory experiment," Journal of Economic Dynamics and Control, Elsevier, vol. 69(C), pages 1-20.
    20. Hazel Bateman & Christine Eckert & Fedor Iskhakov & Jordan Louviere & Stephen Satchell & Susan Thorp, 2017. "Default and naive diversification heuristics in annuity choice," Australian Journal of Management, Australian School of Business, vol. 42(1), pages 32-57, February.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:125:y:2021:i:2:p:254-260. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.