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Healthcare Appointments as Commitment Devices

Author

Listed:
  • Laura Derksen
  • Jason T Kerwin
  • Natalia Ordaz Reynoso
  • Olivier Sterck

Abstract

We show that ordinary appointments can act as effective substitutes for hard commitment devices and increase demand for a critical healthcare service, particularly among those with self-control problems. We show this using an experiment that randomly offered HIV testing appointments and hard commitment devices to high-risk men in Malawi. Appointments more than double testing rates, with effects concentrated among those who demand commitment. In contrast, most men who take up hard commitments lose their investments. Appointments overcome commitment problems without the potential drawback of commitment failure, and have the potential to increase demand for healthcare in the developing world.

Suggested Citation

  • Laura Derksen & Jason T Kerwin & Natalia Ordaz Reynoso & Olivier Sterck, 2025. "Healthcare Appointments as Commitment Devices," The Economic Journal, Royal Economic Society, vol. 135(665), pages 81-118.
    • Handle: RePEc:oup:econjl:v:135:y:2025:i:665:p:81-118.
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    File URL: http://hdl.handle.net/10.1093/ej/ueae077
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    JEL classification:

    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development

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