The World Bank
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NBER Working Papers and Publications
|July 2015||Long Run Effects of Temporary Incentives on Medical Care Productivity|
with Pablo Celhay, Paul Gertler, Paula Giovagnoli: w21361
The adoption of new clinical practice patterns by medical care providers is often challenging, even when they are believed to be both efficacious and profitable. This paper uses a randomized field experiment to examine the effects of temporary financial incentives paid to medical care clinics for the initiation of prenatal care in the first trimester of pregnancy. The rate of early initiation of prenatal care was 34% higher in the treatment group than in the control group while the incentives were being paid, and this effect persisted at least 24 months or more after the incentives ended. These results are consistent with a model where the incentives enable providers to address the fixed costs of overcoming organizational inertia in innovation, and suggest that temporary incentives may be ...
American Economic Journal: Applied Economics (Forthcoming)
|June 2013||Labor Market Returns to Early Childhood Stimulation: a 20-year Followup to an Experimental Intervention in Jamaica|
with Paul Gertler, James Heckman, Rodrigo Pinto, Arianna Zanolini, Susan Walker, Susan M. Chang, Sally Grantham-McGregor: w19185
We find large effects on the earnings of participants from a randomized intervention that gave psychosocial stimulation to stunted Jamaican toddlers living in poverty. The intervention consisted of one-hour weekly visits from community Jamaican health workers over a 2-year period that taught parenting skills and encouraged mothers to interact and play with their children in ways that would develop their children's cognitive and personality skills. We re-interviewed the study participants 20 years after the intervention. Stimulation increased the average earnings of participants by 42 percent. Treatment group earnings caught up to the earnings of a matched non-stunted comparison group. These findings show that psychosocial stimulation early in childhood in disadvantaged settings can have su...
Published: Science 30 May 2014: Vol. 344 no. 6187 pp. 998-1001 DOI: 10.1126/science.1251178 Report Labor market returns to an early childhood stimulation intervention in Jamaica Paul Gertler1,2,*, James Heckman3,4,5, Rodrigo Pinto3, Arianna Zanolini3, Christel Vermeersch6, Susan Walker7, Susan M. Chang7, Sally Grantham-McGregor8
|May 2013||Using Performance Incentives to Improve Medical Care Productivity and Health Outcomes|
with Paul Gertler: w19046
We nested a large-scale field experiment into the national rollout of the introduction of performance pay for medical care providers in Rwanda to study the effect of incentives for health care providers. In order to identify the effect of incentives separately from higher compensation, we held constant compensation across treatment and comparison groups - a portion of the treatment group's compensation was based on performance whereas the compensation of the comparison group was fixed. The incentives led to a 20% increase in productivity, and significant improvements in child health. We also find evidence of a strong complementarity between performance incentives and baseline provider skill.
Published: Journal of Health Economics Volume 40, March 2015, Pages 1–9 Cover image Using provider performance incentives to increase HIV testing and counseling services in Rwanda Damien de Walquea, 1, , , Paul J. Gertlerb, 1, Sergio Bautista-Arredondoc, Ada Kwanc, Christel Vermeerschd, Jean de Dieu Bizimanae, Agnès Binagwahof, Jeanine Condog