{"type":"script","doc_desc":{"producers":[{"name":"Reproducibility WBG","abbr":"DIME","affiliation":"World Bank - Development Impact Department","role":"Verification and preparation of metadata"}],"prod_date":"2024-09-05","version":"1"},"project_desc":{"authoring_entity":[{"name":"Kevin Croke","affiliation":"Harvard T.H. Chan School of Public Health","email":"kcroke@hsph.harvard.edu"},{"name":"Benjamin Daniels","affiliation":"Georgetown University","email":"benjamin.daniels@georgetown.edu"},{"name":"Robert Lipinski","affiliation":"World Bank","email":"rlipinski@worldbank.org"},{"name":"Daniel Rogger","affiliation":"World Bank","email":"drogger@worldbank.org"}],"output":[{"type":"Working paper","title":"Motivating Improved Healthcare Using Holistic Patient Contracts","description":"Policy Research Working Paper (PRWP)"}],"software":[{"name":"R","version":"4.2.1"}],"scripts":[{"file_name":"RR_EST_2024_101","zip_package":"RR_EST_2024_101.zip","title":"Reproducibility package (code) for Motivating Improved Healthcare Using Holistic Patient Contracts","notes":"Computational reproducibility verified by Development Impact (DIME) Analytics team, World Bank.   ","dependencies":"All dependencies and their versions are listed in the file \"renv.lock\" of the reproducibility package."}],"title_statement":{"idno":"RR_EST_2024_101","title":"Reproducibility package for Motivating Improved Healthcare Using Holistic Patient Contracts"},"production_date":"2024-08","abstract":"The implicit contract in most primary healthcare provision has been the responsiveness of doctors to signals of ill-health by patients. For this to be socially optimal, patients must effectively identify underlying health issues or primary care doctors must effectively screen and identify latent conditions. This paper examines the impacts of doctors and patients writing an explicit contract for more holistic primary care. Without punishments for reneging on contract stipulations, the intervention aimed to shift the relational contract between the two parties away from episodic curative care and towards a holistic plan for patient welfare. In a large-scale randomized evaluation of these contracts tracked through the universe of patient records, the program caused changes in doctor activities towards greater screening, diagnosis and treatment of underlying health issues. For mild-risk patients, we see reductions in overall mortality of 40%. Thus, the paper provides evidence that shifts in the nature of the contracting relationship between patients and their care providers can have substantial welfare effects.","geographic_units":[{"name":"Estonia","code":"EST"}],"data_statement":"All data is restricted and has not been included in the reproducibility package.","repository_uri":[{"name":"Reproducible Research Repository (World Bank)","uri":"https:\/\/reproducibility.worldbank.org"}],"technology_requirements":"Runtime: 12 hours","reproduction_instructions":"Users need to gain access to all datasets, open the RStudio project file \"RR_EST_2024_101.Rproj\", run the command \"renv::restore()\" to replicate the project environment, and run the scripts in the folder \"R Scripts\" by following the order in the script prefixes to reproduce the results.","technology_environment":"Paper exhibits were reproduced in a computer with the following specifications:\n\u2022 OS: Windows 10 Enterprise, version 22H2\n\u2022 Processor: Intel(R) Xeon(R) Gold 6226R CPU @ 2.90GHz 2.90 GHz (2 processors)\n\u2022 Memory available: 128 GB\n\u2022 Software version: R 4.2.1 (Funny-Looking Kid)","disclaimer":"The materials in the reproducibility packages are distributed as they were prepared by the staff of the International Bank for Reconstruction and Development\/The World Bank. The findings, interpretations, and conclusions expressed in this event do not necessarily reflect the views of the World Bank, the Executive Directors of the World Bank, or the governments they represent. The World Bank does not guarantee the accuracy of the materials included in the reproducibility package.","license":[{"name":"Modified BSD3","uri":"https:\/\/opensource.org\/license\/bsd-3-clause\/"}],"contacts":[{"name":"Robert Lipinski","affiliation":"World Bank","email":"rlipinski@worldbank.org"},{"name":"Reproducibility WBG","affiliation":"World Bank","email":"reproducibility@worldbank.org"}],"datasets":[{"name":"Health Billing Microdata for Estonia","note":"Source: Estonian Health Insurance Fund. See the README for a list of the files, their location, and data source contact information.","access_type":"Restricted and not included in the package."},{"name":"Diagnoses Microdata for Estonia","note":"Source: Estonian Health Insurance Fund. See the README for a list of the files, their location, and data source contact information.","access_type":"Restricted and not included in the package."},{"name":"Medical Procedures Microdata for Estonia","note":"Source: Estonian Health Insurance Fund. See the README for a list of the files, their location, and data source contact information.","access_type":"Restricted and not included in the package."},{"name":"Prescriptions Microdata for Estonia","note":"Source: Estonian Health Insurance Fund. See the README for a list of the files, their location, and data source contact information.","access_type":"Restricted and not included in the package."},{"name":"Enhanced Care Management RCT Inclusion","note":"Source: Estonian Health Insurance Fund. See the README for a list of the files, their location, and data source contact information.","access_type":"Restricted and not included in the package."},{"name":"Cost of Medical Procedures for Estonia","note":"Source: Estonian Health Insurance Fund. Data was downloaded from the data URL (TORU_2023apr_lisafail.xlsx), translated with Google Translator, and cleaned with the script \"00_Archive\/xx_cost_procedures.R\".","access_type":"Restricted and not included in the package.","uri":"https:\/\/www.tervisekassa.ee\/otsing?keys=lisafai"},{"access_type":"Forthcoming in the World Bank Data Development Hub.","name":"Enhanced Care Management (ECM) Evaluation of the Care Plans","note":"Source: authors' data collection on healthcare evaluation for randomly selected healthcare plans created for ECM. Files location: \"Data\/Raw\/Other\/ECM Evaluation of the care plans.csv\", \"Data\/Raw\/Other\/ECM Evaluation of the care plans-b.csv\"."}]},"tags":[{"tag":"DOI"}],"schematype":"script"}